原发性高血压患者血压变异性与左心室质量指数的相关性分析

目的探讨原发性高血压患者血压变异性(blood pressure variability,BPV)与左心室质量指数(left ventricular mass index,LVMI)的相关性。方法选择我院住院的原发性高血压患者95例,根据心电图、彩色超声心动图检查确定是否伴有左心室肥厚(left ventricular hypertrophy,LVH)分为LVH组42例及无LVH组53例,另选择血压正常且无LVH的健康体检者40例为对照组,收集3组一般临床资料,检测同型半胱氨酸(Hcy)水平,进行24 h动态血压监测,比较3组24 h、夜间、昼间平均血压、收缩压标准差和舒张压标准差及LVMI。结果3组年龄、体质量指数、吸烟、尿酸、血红蛋白、血脂、糖化血红蛋白及各时间段内平均血压比较,差异无统计学意义(P>0.05);3组性别、糖尿病比例、Hcy、肌酐、LVMI及24 h、夜间、昼间收缩压标准差和舒张压标准差比较,差异有统计学意义(P<0.05,P<0.01)。LVH组男性比例、Hcy、LVMI及24 h、夜间、昼间收缩压标准差和舒张压标准差明显高于无LVH组和对照组(P<0.05),LVH组和无LVH组糖尿病比例和肌酐水平明显高于对照组,差异有统计学意义[59.5%和56.6%vs 7.5%,(92.0±4.8)μmol/L和(81.3±15.9)μmol/L vs(65.4±13.2)μmol/L,P<0.05]。无LVH组与对照组LVMI及24 h、夜间、昼间收缩压标准差和舒张压标准差比较,差异无统计学意义(P>0.01)。LVH组非杓型高血压比例明显高于无LVH组和对照组(85.7%vs 34.0%、5.0%,P=0.000)。结论BPV与高血压患者的LVH关系密切,其可能作为靶器官损伤最新的独立预测因素。

Relationship between blood pressure variability and left ventricular mass index in essential hypertension patients

Objective To study the relationships between blood pressure variability(BPV)and left ventricular mass index(LVMI)in essential hypertension patients.Methods Ninety-five essential hypertension patients were divided into left ventricular hypertrophy(LVH)group(n=42)and LVH-free group(n=53)with 40 healthy persons undergoing physical examination served as a control group.Their general clinical data were recorded,their 24 h ambulatory blood pressure(ABP)was mornitored,their 24 h BP,night and day mean BP,SD of SBP and DBP,and LVMI were compared.Results No significant difference was detected in age,BMI,history of smoking,serum levels of UA,hemoglobin,blood lipids,glycosylated hemoglobin and mean BP among the 3 groups(P>0.05).A significant difference was detected in sex,incidence of DM,serum Hcy and creatinine levels,LVMI,SD of nignt and day SBP and DBP among the 3 groups(P<0.05,P<0.01).The ratio of males,serum Hcy and creatinine levels,LVMI,SD of 24 h,night and day SBP and DBP were significantly higher in LVH group than in LVH-free group and control group(P<0.05)while the incidence of DM and serum creatinine level were significantly higher in LVH group and LVH-free group than in control group(59.5%and 56.6%vs 7.5%,92.0±4.8μmol/L and 81.3±15.9μmol/L vs 65.4±13.2μmol/L,P<0.05).No significant difference was detected in LVMI,SD of 24 h,night and day SBP and DBP between LVH-free group and control group(P>0.01).The incidence of non-dipper hypertension was significantly higher in LVH group than in LVH-free group and control group(85.7%vs 34.0%vs 5.0%,P=0.000).Conclusion BPV is closely related with LVH in essential hypertension patients and can thus be used as an independent predictor for target organ damage.