高血压患者动态血压参数与左室肥厚关系探讨

目的探讨高血压患者动态血压参数与左室肥厚的关系。方法采用无创动态血压仪对102例高血压病患者进行24 h动态血压监测及心脏超声检查,根据左室质量指数（LVMI）分2组：左室肥厚组（n=30）与非左室肥厚组（n=72）。结果（1）左室肥厚组与非左室肥厚组的临床指标比较无统计学意义;（2）左室肥厚组与非左室肥厚组的动态血压参数比较,24 h、白昼、夜间收缩压及脉压以及夜间舒张压有统计学意义（P〈0.05）：24 h平均收缩压分别为（146.2±13.5）mm Hg、（125.7±9.2）mm Hg;24 h脉压分别为（59.7±12.7）mm Hg、（46.8±7.1）mm Hg;白天平均收缩压分别为（149.3±10.9）mm Hg、（128.2±10.64）mm Hg,白天脉压分别为（60.2±12.4）mm Hg、（48.1±8.0）;夜间平均收缩压分别为（141.7±16.9）mm Hg、（118.8±9.7）mm Hg;夜间脉压分别为（57.8±14.1）mm Hg、（43.7±6.7）mm Hg;夜间平均舒张压分别为（84.0±10.7）mm Hg、（75.1±7.6）mm Hg。左室肥厚组与非左室肥厚组其动态血压呈非杓型节律为66.7%比30.6%,其差异有非常显著性（P〈0.01）。结论高血压病动态血压参数异常者左室肥厚发生率高,对靶器官损害有预测价值。

A study on the relationship between ambulatory blood pressure monitoring parameters on left ventricular hypertrophy in patients with hypertension

Objective To study the relationship between ambulatory blood pressure monitoring （ ABPM） parameters and left ventricular hypertrophy in patients with hypertension. Methods One hundred and two hypertensive cases including 55 males and 47 females were enrolled in this study. According to LVMI the patients were classified as LVH group （ n = 30 ） and non LVH group （ n = 72 ）. ABPM was performed 24 hours in all the patients. Results （ 1 ） There were no significant differences in clinical manifestation and biochemical parameters between the two groups （ P 〉 0.05 ）. （ 2 ） The parameters of ABPM in the LVH group were higher than those in the non LVH group. There were significant differences （ P 〈 0.05 ） in 24h mean systolic blood pressure （146. 2 ±13. 5 ） mm Hg：（125.7±9.2） mm Hg;24 hpulsepressure（59.7±12.7） mm Hg：（46.8±7.1） mm Hg;daytime mean systolic blood pressure（ 149. 3 ± 10. 9） mm Hg： （128. 2 ± 10. 64 ） mm Hg; day time pulse pressure （ 60. 2 ± 12. 4 ） mm Hg： （ 48. 1 ± 8.0 ） ; nighttime mean systolic blood pressure （ 141.7 ± 16. 9 ） mm Hg ： （ 118.8 ± 9.7 ） mm Hg;nighttime pulse pressure（57.8 ± 14. 1 ）mm Hg： （43.7 ± 6. 7 ） mm Hg and nighttime mean diastolic blood pressure（ 84.0 ± 10. 7） mm Hg： （75. 1 ±7. 6） mm Hg;the non-dippers rhythm of ambulatory blood pressure 66.7% ：30.6%. Conclusion There is a higher incidence of LVH in the hypertensives whose ABPM parameters were abnomal. The ABPM parameters have prognostic value in estimating the degree of target organ damage in hypertension.