老年高血压患者血压昼夜节律异常对左心室功能的影响

目的：研究老年高血压患者血压昼夜节律异常对左心室功能的影响。方法选取2010年5月～2014年5月本院收治的老年高血压患者150例，其中夜间血压下降率≥10%者为对照组（n=61例），夜间血压下降率〈10%者为研究组（n=89例），所有患者均给予24 h动态血压监测以及超声心动图检测，比较两组患者的血压昼夜节律以及左心室功能特点。结果研究组24 h收缩压、24 h舒张压、夜间收缩压以及夜间舒张压显著高于对照组，两组比较差异有统计学意义（P〈0.05）；研究组患者左心室舒张早期的血流峰值流速减慢，二尖瓣E峰值和二尖瓣A峰值的比较（E/A）显著高于对照组，两组比较差异有统计学意义（P〈0.05），两组左心室射血分数比较差异无统计学意义（P〉0.05）。结论血压昼夜节律异常的老年高血压患者相比血压昼夜节律变化正常者，更容易引起左心室舒张功能减退。

Influence of abnormal circadian rhythm of blood pressure in elderly pa-tients with essential hypertension on left ventricular function

Objective To investigate the influence of abnormal circadian rhythm of blood pressure in patients of senile hypertension on left ventricular function. Methods 150 elderly patients with hypertension from May 2010 to May 2014 in our hospital were selected,the patients whose nocturnal blood pressure decline rate≥10% as control group （n=61）, nocturnal blood pressure decline rate〈10% as observation group （n=89）,all patients were given detection of 24 hours ambulatory blood pressure testing and ultrasonic beckoning diagram,circadian rhythm of blood pressure and left ventricular function were compared between two groups of patients. Results The 24 hours systolic blood pressure （24 h SBP）, 24 hours diastolic blood pressure（24 h DBP）,night systolic blood pressure （night SBP） and night diastolic blood pressure （night DBP） in observation group were significantly higher than that of control group,with significant differences between the two groups （P〈0.05）.Peak flow velocity decreased of observation group at the early left ventricular diastole,its compared of mitral A peak and mitral E peak （E/A） was significantly higher than that of control group,with significant differences between the two groups （P〈0.05）,two groups of left ventricular ejection fraction （LVEF） had no significant difference （P〉0.05）. Conclusion The circadian rhythm of blood pressure of in elderly hypertensive patients is more likely to cause left ventricular diastolic dysfunction than the circadian rhythm of blood pressure of configuration.