高血压病患者动态血压负荷与左室肥厚及颈动脉硬化的相关性研究

 目的 探讨高血压病患者动态血压负荷与左室肥厚及颈动脉硬化的相关性.方法 将明确诊断的高血压病患者65例行超声心动图和颈动脉超声、动态血压监测检查,将上述参数、血脂等指标进行比较.根据左室质量指数将患者分成左室肥厚组(n=20,占31%)和非左室肥厚组(n=45,占69%);根据颈动脉内-中膜厚度分为颈动脉粥样硬化组(n=23,占35%)及颈动脉正常组(n=42,占65%).结果 (1)左室肥厚组与非左室肥厚组临床指标比较差异无统计学意义(P>0.05); 左室肥厚组24 h收缩压负荷(24 h SBPL)、24 h舒张压负荷(24 h DBPL)、夜间收缩压负荷(nSBPL)、夜间舒张压负荷(nDBPL)、白天收缩压负荷(dSBPL)显著高于非左室肥厚组(P<0.01).(2)颈动脉粥样硬化组与颈动脉正常组临床指标比较差异无统计学意义(P>0.05);颈动脉粥样硬化组24 h SBPL、24 h DBPL、nSBPL、nDBPL显著高于颈动脉正常组(P<0.01).结论 (1)高血压病动态血压负荷异常者左室肥厚及颈动脉硬化的发生率增多;(2)高血压患者应常规进行颈动脉检查,尤其是伴有左室肥厚的高血压患者.

Associations of dynamic blood pressure load with left ventricular hypertrophy and carotid artery atherosclerosis in hypertensive patients

Objective To investigate the associations of dynamic blood pressure load with left ventricular hypertrophy （LVH） and carotid artery atherosclerosis in hypertensive patients.Methods Sixty- five patients with mild- to- mederate essential hypertension, younger than 55 years, were studied. 24h ambulatory blood pressure monitoring, carotid ultrasonographic and echocardiographic study were performed on all subjects. The biochemical parameters, such as blood lipids and others, were tested. Then the data were compared. According to LV mass index（LVMI） and carotid intima- media thickness （IMT） values, all patients were divided into groups with and without LVH （ n = 20 and 45, respectively）, and IMT increased group and normal IMT group （ n = 23 and 42, respectively）. Results （ 1 ） There were no significant differences in clinical manifestations and biochemical parameters between the groups with LVH and without LVH （ P 〉 0.05） ;the levels of 24 h SBPL,24 h DBPL, nSBPL, nDBPL, and dSBPL in LVH group were higher than those in the group without LVH （ P 〈 0.01 ）. （2） There were also no sigaaificant differences in clinical manifestations between the IMT increased and normal IMT groups （ P 〉 0.05） ; the levels of 24 h SBPL,24 h DBPL, nSBPL, nDBPL, and dSBPL in IMT increased group were higher than those in the group with normal IMT（ P 〈 0.01 ）. Condusiolls （ 1 ） There are more LVH or IMT increased patients in the hypertensives whose dynamic blood pressure load is abnormal. （2） IMT evaluation has to be recotrmaended in hypertensive patients with LVH.