中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2014年
8期
602-606
,共5页
高血压%血压昼夜节律%心功能
高血壓%血壓晝夜節律%心功能
고혈압%혈압주야절률%심공능
Hypertension%Blood pressure circadian rhythm%Cardiac function
目的：研究高血压患者不同血压昼夜节律对心功能的影响。<br> 方法：选择昼间血压控制良好的高血压患者180例，根据血压昼夜节律不同划分为杓型组30例、非杓型组99例和反杓型组51例,测定心功能，分析心功能改变与临床相关指标及血压昼夜节律间的关系。<br> 结果：杓型组、非杓型组和反杓型组三组间平均收缩压、平均舒张压、高血压分级及降压药物使用差异均无统计学意义。①脉冲多普勒二尖瓣E峰与组织多普勒二尖瓣环E'峰之比值（E/E'）在杓型组、非杓型组及反杓型组依次升高（8.1±2.4，8.6±2.5，9.6±3.2，P<0.05），三组比较差异有统计学意义。②左心房容积指数反杓型组和非杓型组大于杓型组[（43.8±11.8）ml/m2，（40.7±9.8）ml/m2，（36.6±8.5）ml/m2，P<0.05或P<0.01]，差异均有统计学意义。③E/E'与夜间收缩压、年龄呈正相关，而与夜间血压下降率（BPR）呈负相关，其中与年龄及夜间BPR独立相关；左心房容积指数与夜间收缩压、脉压、年龄、高血压病程呈正相关，与平均舒张压、昼间舒张压、夜间BPR呈负相关，其中与夜间BPR、脉压、高血压病程独立相关。三组间比较左心室射血分数差异无统计学意义。<br> 结论：血压昼夜节律异常与高血压患者的心脏损害有关，从非杓型组到反杓型组心功能损害逐渐加重，以舒张功能损害为主。
目的：研究高血壓患者不同血壓晝夜節律對心功能的影響。<br> 方法：選擇晝間血壓控製良好的高血壓患者180例，根據血壓晝夜節律不同劃分為杓型組30例、非杓型組99例和反杓型組51例,測定心功能，分析心功能改變與臨床相關指標及血壓晝夜節律間的關繫。<br> 結果：杓型組、非杓型組和反杓型組三組間平均收縮壓、平均舒張壓、高血壓分級及降壓藥物使用差異均無統計學意義。①脈遲多普勒二尖瓣E峰與組織多普勒二尖瓣環E'峰之比值（E/E'）在杓型組、非杓型組及反杓型組依次升高（8.1±2.4，8.6±2.5，9.6±3.2，P<0.05），三組比較差異有統計學意義。②左心房容積指數反杓型組和非杓型組大于杓型組[（43.8±11.8）ml/m2，（40.7±9.8）ml/m2，（36.6±8.5）ml/m2，P<0.05或P<0.01]，差異均有統計學意義。③E/E'與夜間收縮壓、年齡呈正相關，而與夜間血壓下降率（BPR）呈負相關，其中與年齡及夜間BPR獨立相關；左心房容積指數與夜間收縮壓、脈壓、年齡、高血壓病程呈正相關，與平均舒張壓、晝間舒張壓、夜間BPR呈負相關，其中與夜間BPR、脈壓、高血壓病程獨立相關。三組間比較左心室射血分數差異無統計學意義。<br> 結論：血壓晝夜節律異常與高血壓患者的心髒損害有關，從非杓型組到反杓型組心功能損害逐漸加重，以舒張功能損害為主。
목적：연구고혈압환자불동혈압주야절률대심공능적영향。<br> 방법：선택주간혈압공제량호적고혈압환자180례，근거혈압주야절률불동화분위표형조30례、비표형조99례화반표형조51례,측정심공능，분석심공능개변여림상상관지표급혈압주야절률간적관계。<br> 결과：표형조、비표형조화반표형조삼조간평균수축압、평균서장압、고혈압분급급강압약물사용차이균무통계학의의。①맥충다보륵이첨판E봉여조직다보륵이첨판배E'봉지비치（E/E'）재표형조、비표형조급반표형조의차승고（8.1±2.4，8.6±2.5，9.6±3.2，P<0.05），삼조비교차이유통계학의의。②좌심방용적지수반표형조화비표형조대우표형조[（43.8±11.8）ml/m2，（40.7±9.8）ml/m2，（36.6±8.5）ml/m2，P<0.05혹P<0.01]，차이균유통계학의의。③E/E'여야간수축압、년령정정상관，이여야간혈압하강솔（BPR）정부상관，기중여년령급야간BPR독립상관；좌심방용적지수여야간수축압、맥압、년령、고혈압병정정정상관，여평균서장압、주간서장압、야간BPR정부상관，기중여야간BPR、맥압、고혈압병정독립상관。삼조간비교좌심실사혈분수차이무통계학의의。<br> 결론：혈압주야절률이상여고혈압환자적심장손해유관，종비표형조도반표형조심공능손해축점가중，이서장공능손해위주。
Objective: To investigate the inlfuence of different blood pressure (BP) circadian rhythm on cardiac function in hypertensive patients. <br> Methods: A total of 180 hypertensive patients with well controlled day-time blood pressure were divided into 3 groups. Dipper group, n=30, Non-dipper group, n=99 and Reverse dipper group, n=51. The relationship between cardiac function, relevant clinical index and blood pressure circadian rhythm were analyzed. <br> Results: The mean systolic and diastolic BP, BP classiifcation and the antihypertensive medication were similar among 3 groups.①The ratio of peak mitral E wave to peak mitral annulus E' wave (E/E') increased accordingly from Dipper group, Non-dipper group and Reverse-dipper group as (8.1 ± 2.4), (8.6 ± 2.5) and (9.6 ± 3.2), P<0.05. ②Left atrial volume index (LAVi) in Reverse-dipper and Non-dipper groups were higher than that in Dipper group as (43.8 ± 11.8) ml/m2, (40.7 ± 9.8) ml/m2 and (36.6 ± 8.5) ml/m2, P<0.05 or P<0.01. ③E/E' was positively related to nocturnal systolic BP and age, negatively related to nocturnal BP decline rate (nocturnal BPR); E/E' was independently related to age and BPR. LAVi was positively related to nocturnal systolic BP, pulse pressure, age and hypertension course, negatively related to the mean diastolic BP, day-time diastolic BP and BPR; LAVi was independently related to BPR, pulse pressure and hypertension course. Left ventricular ejection fraction had no statistic differences among 3 groups. <br> Conclusion: Abnormal blood pressure circadian rhythm was associated with the cardiac injury in hypertensive patients. The cardiac injury increased accordingly from Non-dipper group to Reverse-dipper group and the main damage was in diastolic function.
