摘要
目的探讨高血压患者动态血压变异性(BPV)与左心室重构的关系。方法选择2018年6月至2020年6月北京大学首钢医院全科收治的85例高血压患者为研究对象,按照左心室重构情况分为左心室肥厚组(40例)和非左心室肥厚组(45例),两组均进行动态血压监测并比较获得的收缩压(SBP)、舒张压(DBP)、BPV指标,心室重构指标[左心室质量指数(LVMI)、相对室壁厚度(RWT)],左心室舒张功能指标[左心室舒张早期血流峰值速度(E)/左心室舒张晚期血流峰值速度(A)、二尖瓣外环舒张早期运动速度(Em)、E/Em、Tei指数]。结果左心室肥厚组以24 h SBP、昼SBP、夜SBP显著高于非左心室肥厚组[(148.3±3.5)mmHg(1 mmHg=0.133 kPa)比(141.0±1.3)mmHg,(149.1±5.3)mmHg比(142.1±2.1)mmHg,(145.1±4.5)mmHg比(143.0±1.2)mmHg](P<0.01),两组其他动态血压指标比较差异无统计学意义(P>0.05)。左心室肥厚组24 h收缩压标准差(SSD)、昼SSD、夜SSD、24 h SBP-BPV及24 h DBP-BPV高于非左心室肥厚组(P<0.05)。左心室肥厚组LVMI、RWT显著高于非左心室肥厚组(P<0.01)。左心室肥厚组E/A、Em低于非左心室肥厚组,E/Em、Tei指数高于非左心室肥厚组(P<0.05)。LVMI与Tei指数、E/Em及昼SSD均呈正相关(r=0.342,P=0.002;r=0.608,P=0.000;r=0.316,P=0.032);昼SSD与E/Em、Tei指数均呈正相关(r=0.386,P=0.003;r=0.281,P=0.042)。结论动态血压监测BPV对高血压左心室重构情况有良好的提示意义,在高血压治疗方面,不仅要控制血压还要防治左心室重构。
Objective To investigate the relationship between blood pressure variability(BPV)and left ventricular remodeling in hypertensive patients.Methods A total of 85 hypertensive patients admitted to the general practice of Peking University Shou Gang Hospital from Jun.2018 to Jun.2020 were included.According to left ventricular remodeling,they were divided into a left ventricular hypertrophy group(n=40)and a non-left ventricular hypertrophy group(n=45).Systolic blood pressure(SBP),diastolic blood pressure(DBP),BPV,ventricular remodeling indexes[left ventricular mass index(LVMI),relative wall thickness(RWT)],left ventricular diastolic function index[left ventricular early diastolic peak velocity(E)/left ventricular late diastolic velocity(A),external mitral ring early diastolic velocity(Em),E/Em,Tei index]were compared between the two groups.Results 24 h SBP,day SBP and night SBP in the left ventricular hypertrophy group were significantly higher than those in the non-left ventricular hypertrophy group[(148.3±3.5)mmHg(1 mmHg=0.133 kPa)vs(141.0±1.3)mmHg,(149.1±5.3)mmHg vs(142.1±2.1)mmHg,(145.1±4.5)mmHg vs(143.0±1.2)mmHg](P<0.01),and there was no significant difference in other ambulatory blood pressure indexes between the two groups(P>0.05).The standard deviation of 24 h systolic blood pressure(SSD),day SSD,night SSD,24 h SBP-BPV and 24 h DBP-BPV in the left ventricular hypertrophy group were higher than those in the non-left ventricular hypertrophy group(P<0.05).LVMI and RWT in the left ventricular hypertrophy group were significantly higher than those in the non-left ventricular hypertrophy group(P<0.01).The E/A and Em of the left ventricular hypertrophy group were lower than those of the non-left ventricular hypertrophy group,and the E/Em and Tei index were higher than those of the non-left ventricular hypertrophy group(P<0.05).LVMI was positively correlated with Tei index,E/Em and day SSD(r=0.342,P=0.002;r=0.608,P=0.000;r=0.316,P=0.032);day SSD was positively correlated with E/Em and Tei index(r=0.386,P=0.003;
作者
陈新
程丽兰
张潇文
程洁
CHEN Xin;CHENG Lilan;ZHANG Xiaowen;CHENG Jie(Department of General Practice,Peking University Shou Gang Hospital,Beijing 100041,China;Department of Emergency,Peking University Shou Gang Hospital,Beijing 100041,China)
出处
《医学综述》
CAS
2022年第21期4365-4368,F0003,共5页
Medical Recapitulate
关键词
高血压
动态血压监测
血压变异性
High blood pressure
Ambulatory blood pressure monitoring
Blood pressure variability
