超高龄高血压病患者动态血压和左室肥厚关系的研究

目的研究超高龄（≥80岁）高血压病患者动态血压监测与左室肥厚的关系及临床意义。方法按年龄将296例被观察者分为超高龄高血压组（116例）、老年高血压组（90例）、中青年高血压组（90例），采用动态血压监测及超声心动图观察平均动脉压、昼夜收缩压（24h SBP）、舒张压（DBP）水平和左室重量指数（LVMI）等。结果24h SBP、nSBP、nSBP／dSBP、SBPL和LVH正相关，单纯收缩期高血压ISH、血压昼夜节律消失BPRD的发生率和LVH的发生率正相关。随着年龄的增加，室内隔厚度（IVST）、左室舒张末期内径（LVDd）、左室后壁厚度（LVPW）和LVMI逐渐增加，有统计学意义（分别为P〈0．05，P〈0．01），（ISH）、（BPRD）和左心室肥厚（LVH）的发生率明显增高，有统计学意义（分别为P〈0．05，P〈0．01）。结论24h sbp、nSBP、nSBP／dSBP、SBPL与老年高血压患者的左心室肥厚关系密切，单纯收缩期高血压（ISH）和非杓型高血压更易发生左心室肥厚。年龄增加是左心室肥厚的一个重要因素。

A study of relationship between ambulatory blood pressure and left ventricular hypertrophy in very elderly hypertensive patients

Objective:To explore the relation between the parameter of ambulatory blood pressure monitoring (ABPM) and left ventricular hypertrophy (LVH) and the clinical significance in very elderly hypertensive patients.Methods:296 essential hypertensive patients were divided into three groups by age.They were very elderly group,elderly group,and young and middle-age group (116,90 and 90,respectively).The ambulatory blood pressure was measured for 24 hours and the left ventricular mass indexer (LVMI) were measured with echocardiography according to Devereur's correction for- mula.Results:24h sbp,nSBP,nSBP/dSBP and SBPL had positive correlation with LVH.IVST,LVDD,LVPW and LV- MI were significantly higher in very eldly hypertensives than those of elderly hypertensives and young and middle-age hyper- tensives(P<0.05,P<0.01,respectively).The incidence rate of isolated systolic hypertension (ISH),blood pressure rhythm disappeared (BPRD) and LVH were also significantly higher in very elderly than those of elderly hypertensives and young and middle-age hypertensives(P<0.05,P<0.01,respectively).Conclusion:24h sbp,nSBP,nSBP/dSBP and SB- PL are the important factors affecting LVH in very elderly hypertensive patients.ISH and Non-dipper induce LVH more easily.Aging is an important factor of LVH.