老年原发性高血压患者动态脉压与左心室质量指数关系的研究

目的探讨老年原发性高血压动态脉压与左心室质量指数（LVMI）的关系。方法收集2012年1月一12月住院的110例老年原发性高血压患者的临床资料。所有患者均已行动态血压检测，并行超声心动图检查，依据24h动态血压结果计算动态脉压，依据超声心动图结果计算LVMI，按照脉压〈60mmHg（1mmHg=0．133kPa）以及≥60mmHg将患者分为A组（n=70）和B组（n=40），比较两组患者的LVMI等指标，并采用多重线性逐步回归分析动态脉压与LVMI的关系。结果B组患者的24h平均收缩压、动态脉压较A组明显增高（P〈0．001）；B组患者的室间隔厚度、左心室后壁厚度、左心室质量、LVMI均高于A组（P〈0．05）；Pearson相关分析显示：动态脉压与LVMI呈正相关（r=0．33，P〈0．001）；多重线性逐步回归显示：动态脉压是LVMI增加的危险因素（β=0．90，P〈0．001）。结论老年原发性高血压患者动态脉压与LVMI呈正相关，动态脉压是老年原发性高血压患者左心室结构损害的重要危险因素。

The Relationship between the 24-hour Ambulatory Pulse Pressure and Left Ventricular Mass Index in Elderly Patients with Essential Hypertension

Objective To investigate the relationship of 24-hour ambulatory pulse pressure （24hPP） with left ventricular mass index （LVMI） in elderly essential hypertension patients. Methods The data of 110 elderly patients with essential hypertension from January to December 2012 were collected in the study. All patients received 24-hour ambulatory blood pressure monitoring and echoeardiographic examination 24hPP and LVMI were calculated according to the results of 24-hour ambulatory blood pressure monitoring and echocardiographic measurements. The patients were divided into group A 24hPP 〈 60 mm Hg （1 mm Hg=0.133 kPa）, n=70] and group B （24hPP ≥ 60 mm Hg, n=40）. Results The 24-hour systolic blood pressure and 24hPP for patients in group B were significantly higher than those in group A （P 〈 0.001）. Compared with group A patients, the interventricular septal thickness, left ventricular posterior wall thickness, left ventricular mass and left vantricular mass index were significantly higher in group B （P 〈 0.05）. Pearson correlation analysis showed that 24hPP had a positive correlation with LVMI in the elderly essential hypertension patients （r=0.33, P 〈 0.001）. Multiple stepwise regression analysis showed that 24hPP was the main factor for the increase of LVMI in elderly essential hypertension patients （β=0.90, P 〈 0.001）. Conclusions The 24hPP is positively correlated with LVMI in elderly essential hypertension patients. The 24hPP is an important risk factor for left ventricular structural damage in elderly essential hypertensive patients.