老年高血压病患者动态血压与左室肥厚的关系探讨.docVIP

老年高血压病患者动态血压与左室肥厚的关系探讨 作者:吴仕英，丁光明，董天宏，刘俊 【摘要】 目的 分析老年高血压病患者动态血压参数与左室肥厚（LVH）的关系。方法 对128例老年（≥60岁）高血压病患者依据是否伴有左心室肥厚分为左室肥厚组（LVH）与不伴有左室肥厚（NLVH）组，进行24h动态血压（ABPM）检测。比较两组间动态血压参数与左室肥厚的关系。结果 （1）LVH组与不伴有LVH组比较，24hSBP、24hPP、dSBP、nSBP、BPF、BPL、LVMI差异有显著性（P＜0.01或0.05）；（2）LVH组以非杓型血压为主，占75％，而不伴有LVH组，以杓型血压为主，占79.41％；（3）LVH组LVMI与24hSBP、24hPP、dSBP、nSBP、SBPL正相关(r=0.477～0.795，P＜0.001)，与SBPF、DBPF负相关(r=-0.358，-0.289，P＜0.01)。结论 老年高血压病左室肥厚的发生与SBP、24hPP、SBPL和BPF相关。 【关键词】 老年高血压病； 动态血压监测； 左室肥厚； 昼夜节律 Relationship between ambulatory blood pressure and left ventricular hypertrophy in elderly patients with hypertension 【Abstract】 Objective To observe the relationship between the parameters of ambulatory blood pressure and left ventricular hypertrophy (LVH)in elderly patients with hypertension.Methods Ambulatory blood pressure monitoring (ABPM) was performed in 128 cases of hypertension，which were divided into LVH group or non- LVH group by the echocardiography，observe the relationship between the parameters of ABPM and LVH．Results （1）24hSBP，dSBP，nSBP，BPL，24hPP，BPF and LVMI were significantly increased in the group with LVH and that in the group without LVH(P＜0.01 or lt;0.05). (2) Patients with non-dipper type hypertension were 45 cases (75%)in 60 patients with LVH. Patients with dipper type hypertension were 54 cases (79.41 %)in 68 hypertension patients with non-LVH. (3)By regression analysis in group LVH，the 24hSBP，24hPP，dSBP，nSBP and SBPL had significant positive correlations with LVMI(r=r=0.477～0.795，P＜0.001)，while SBPF and DBPF had remarkable negative correlation with LVMI(r=-0.358，-0.289，P＜0.01)．Conclusion The occurrence of left ventricular hypertrophy in elderly patients with hypertension was related with SBP，24hPP，SBPL and BPF. 【Key words】 aged hypertension；ambulatory blood pressure monitoring；left ventricular hypertrophy；circadian rhythm 为探讨老年高血压疾病患者动态血压参数与左室肥厚（LVH）的关系。我们收集了自1999年12月～2005年12月我院住院及心血管专科门诊老年高血压患者资料完整的病人128例，对其进行ABP