原发性高血压与肾性高血压的动态血压特点及其与心肌肥厚的关系

目的：观察原发性高血压与肾性高血压的动态血压特点，以了解其造成心肌肥厚的原因。方法：将未予治疗的高血压患分为原发性高血压组64名，肾性高血压组64名，比较2组的脉压（PP）、血压变异性（BPV）、白天平均收缩压（dSBP)、白天平均舒张压（dDBP),夜间平均收缩压（nSBP)、夜间平均舒张压（nDBP);彩色多普勒测定心肌重量指数（LVMI），统计分析LVMI与各动脉血压指标的相关性。结果：肾性高血压组的PP、BPV、LHVI较原发性高血压组明显增高，2组的dSBP、dDBP、nSBP、nDBP差异无显性；2组的LHVI均与PP、BPV明显相关。结论：原发性高血压与肾性高血压的心肌肥厚均与PP、BPV相关，提示PP、BPV可能是心肌损害的预测因子；而在平均动脉压相同的情况下，肾性高血压比原发性高血压对心肌的损害作用更大。

Relationship between ambulatory blood pressure monitoring in patients with essential or renal hypertension and left ventricular function

Objectives To observe the features of ambulatory blood pressure monitoring (ABPM) in essential hypertension (EHT) and renal hypertension that contribute to left ventricular hypertrophy (LVH). Methods 128 patients were divided into EHT group (64) and renal hypertension group (64) with each patients diagnosed to have LVH by echocar-diography. ABPM was performed and pulse pressure (PP), blood pressure variability (BPV), day-systolic pressure ( dSBP ), day diastolic pressure ( dDBP ) , night systolic pressure (nSBP), night diastolic bloodpressure (nDBP) were calculated. Compare these indexes of the 2 groups and statistic the relatonsinp of LVMI between above indexes. Results There were no difference between the two groups in dSBP, dDBP, nSBP, nDBP, but PP, BPV, LVMI in renal group was ingher than in EHT group. LHVI was positive connected with PP and BPV in two groups. Conclusions PP and BPV may be the predict factors to heart damage in hypertension patients, and renal hypertension does more harm to heart than ETH.