原发性高血压病患者昼夜血压节律异常与左心室肥厚的关系

目的：观察原发性高血压病患者昼夜节律与左心室肥厚的关系。方法：134例原发性高血压病患者采用动态血压监测仪测定动态血压,采用心超评价左心室肥厚情况,分析血压节律和左心室肥厚的关系。结果：134例高血压患者中,节律异常的非杓型血压患者13例（9.7%）。血压节律异常与性别、年龄、BMI和高血压严重程度等方面均无关（P〉0.05）,而和心室重量指数有关（t=7.913,P=0.000）。非杓型血压组左心室肥厚发生率为69.2%,高于杓型血压组左心室肥厚发生率为18.2%（χ^2=17.203,P=0.000）,OR值为10.125,95%CI为2.488～48.010。Logistic回归分析显示血压节律异常和高血压严重程度、血压控制情况及脉压大小同是引起高血压并发左心室肥厚的独立危险因素。结论：原发性高血压病患者的昼夜节律异常容易并发左心室肥厚。因此在高血压的治疗中除了控制血压的绝对值外,还应注意调节血压的正常生理节律。

The relationship between abnormal circadian rhythm of blood pressure and left ventricular hypertrophy in patients with hypertension

Objective： To observe the relationship between abnormal circadian rhythm of blood pressure and left ventricular hypertrophy in patients with hypertension. Methods： Used ambulatory blood pressure to monitor the blood pressure in 134 patients with primary hypertension,left ventricular hypertrophy was measured by cardiac ultra-evaluation. Results： In 134 patients with hypertension,13 patients with non-dipper blood pressure（9.7%）. Blood pressure rhythm abnormalities had no relationship with gender,age,BMI（P0.05）, but related with ventricular weight index （t=7.913,P=0.000）. The incidence of left ventricular hypertrophy in non-dipper blood pressure group was 69.2%,higher than that of 18.2% in the dipper blood pressure group （χ^2=17.203,P=0.000）, The OR value 10.125, 95% CI of 2.488-48.010. Logistic regression analysis showed that blood pressure rhythm abnormalities, hypertension severity, blood pressure controls and pulse pressure were the indepen-dent risk factor for left ventricular hypertrophy in patients with essential hypertension. Conclusion： The circadian rhythm abnormalities of patients with hypertension are easy to complicate with left ventricular hypertrophy. Therefore, in the treat-ment of hypertension, we must also regulate the normal physiological of blood pressure rhythm.