白大衣高血压患者血压变异性对靶器官损害的影响

目的探讨血压变异性对白大衣高血压患者靶器官损害的影响。方法门诊患者119例,根据24 h动态血压和诊室血压分为正常血压组(NT)和白大衣高血压组(WCH)。其中白大衣高血压组根据24 h收缩压变异程度分为:白大衣高血压血压变异性低组(WCH-L),白大衣高血压血压变异性高组(WCH-H)。心脏和颈动脉超声检查:计算二尖瓣环心肌舒张早期峰值运动速度(Em)与舒张晚期峰值运动速度(Am)比值(Em/Am),评价左心室舒张功能及颈动脉损害的发生率。结果 (1)NT组左心室舒张功能减退发生率(21.87%,7例/32例)、颈动脉损害的检出率(18.75%,6例/32例)与WCH-L组(31.11%,14例/45例;22.22%,10例/45例)相近,组间差异无统计学意义(P=0.370、0.711);(2)WCH-H组左心室舒张功能减退发生率(52.38%,22例/42例)、颈动脉损害的检出率(42.85%,18例/42例)明显高于NT组(P=0.008、0.028)和WCH-L组(P=0.044、0.040),差异均有统计学意义。结论血压变异性较大的白大衣高血压患者具有较高的靶器官损害发生率。

Influence of blood pressure variability on left ventricular diastolic function and carotid damage inwhite coat hypertension patients

Objective To evaluate the influence of blood pressure variability （BPV） on left ventricular diastolic function （LVDF） and carotid atherosclerosis in patients with white coat hypertension （WCH）. Methods Our study consisted of 119 out-patients with WCH （office blood pressure ≥140/90 mmHg and daytime blood pressure 〈 135/85 mmHg, n = 87） and 32 age and sex matched nonnotensive （NT） controls. According to 24-hour systolic blood pressure variability （SBPV）, 87 WCH patients were subdivided into two groups： high SBPV （WCH-H） group and low SBPV （WCH-L） group. Left ventricular diastolic function and carotid damage were evaluated by Doppler ultrasound. Results There were no significant differences between NT and WCH-L group in the rates of left ventricular diastolic dysfunction and carotid damage （21.87% vs. 31.11% , P =0.370 and 18.75% vs. 22.22% , P =0.711, respectively）. Compared with NT and WCH-L group, patients in WHC-H group had significantly higher left ventricular diastolic dysfunction rate （52. 38% ） and carotid damage rate （42. 85% ） （all P 〈 0. 05 ）. Conclusions WCH patients with higher BPV has significantly higher target organ damage rate.