难治性高血压患者左心室肥厚的危险因素分析

目的:探讨难治性高血压(RH)患者左心室肥厚(LVH)的独立危险因素.方法:回顾性分析120例RH患者病历资料.根据超声心动图检测结果计算左室质量指数(LVMI),将RH患者分为LVH组69例和非LVH组51例.收集患者基本资料(性别、年龄、病程等)、24 h动态血压资料、血液生化指标等.通过两组间差异分析、单因素及多因素logistic回归分析RH左心室肥厚的独立危险因素.结果:LVH组高血压病程、早发心血管病家族史、超重、血糖异常、C反应蛋白(CRP)、各动态血压参数异常均明显高于非LVH组(P<0.01).多元回归分析显示,24 h平均收缩压(24hSBP)、舒张压(24hDBP)、平均动脉压(MAP)等动态血压异常与RH患者LVH独立相关.结论:动态血压参数异常者左心室肥厚发生率高,有效地控制血压及加强对RH患者危险因素的监测,对高危患者进行针对性地防治,有重要的临床意义.

The Analysis of Risk Factors in Patients with Resistant Hypertension and Left Ventricular Hypertrophy

Objective：To investigate the independent risk factors of left ventricular hypertrophy （LVH） in patients with resistant hypertension （RH）.Methods ：The clinical of 120 patients with RH were analyzed retrospectively. According to left ventrieular mass indices （LVMI） which were calculated by ultrasonic cardiogram （UCG）, the cases were divided into LVH＇group （n=69） and non-LVH group （n=51）. The clinical data of the cases were collected, including gender, age, diseases course, the parameters of 24-hour ambulatory blood pressure monitoring （ABPM）, blood biochemical index. The corresponding data were compared by means of statistics between the two groups, the univariate and multivariate logistic regression were performed to estimate the independent risk factors of LVH in patients with RH. Results ： Diseases course, early onset cardiovascular family history, overweight, pathoglycemia, CRP, the parameters of ABPM in the LVH group were significantly higher than those in the non-LVH group（P〈0.01）. The independent risk factors for LVH include 24hSBP, 24hDBP, 24hMAP. Conclusion：There is a higher incidence of LVH in RH whose ABPM parameters were abnormal. There is important clinical significance to reinforce monitoring the risk factor of RH, and to perform pertinent treatment and prevention for the high risk cases.