CAJ | 학술논문

目的探讨高血压患者动态血压与心肌做功指数(MPI)的关系.方法连续纳入2013年1—6月于北京大学第三医院心内科就诊的、未经治疗的高血压患者76例,行诊室血压、24h动态血压测量及超声心动图检查.计算得到所有患者的MPI,公式为:MPI=(等容收缩时间+等容舒张时间)/射血时间.根据左心室MPI将患者分为MPI ＞0.47组(n=38)和≤0.47组(n=38),比较两组的平均诊室血压、平均动态血压、血压负荷、血压晨峰(清晨血压与夜间最低血压之间的差值)和血压昼夜节律.用多因素线性回归分析来确定MPI的独立相关因素.结果 MPI＞0.47组和≤0.47组相比,MPI高组的24h和日间平均收缩压、24 h、日间和夜间平均舒张压、24h、日间和夜间收缩压负荷、24h、日间和夜间舒张压负荷及收缩压晨峰均显著高于MPI低组(均P＜0.05),而平均诊室收缩压和舒张压、夜间平均收缩压、舒张压晨峰、夜间收缩压和舒张压较日间下降的百分比两组间差异均无统计学意义(均P＞0.05).多因素回归分析显示,夜间平均舒张压(β=0.285,P=0.005)、日间收缩压负荷(β=0.397,P＜0.001)与MPI独立相关;其他与MPI独立相关的因素为左心室重量指数(LVMI)和二尖瓣环侧壁舒张早期运动峰速度(Em).结论动态血压水平和血压负荷的增加伴随左心室MPI的升高.
목적 탐토고혈압환자동태혈압여심기주공지수(MPI)적관계.방법 련속납입2013년1—6월우북경대학제삼의원심내과취진적、미경치료적고혈압환자76례,행진실혈압、24h동태혈압측량급초성심동도검사.계산득도소유환자적MPI,공식위:MPI=(등용수축시간+등용서장시간)/사혈시간.근거좌심실MPI장환자분위MPI ＞0.47조(n=38)화≤0.47조(n=38),비교량조적평균진실혈압、평균동태혈압、혈압부하、혈압신봉(청신혈압여야간최저혈압지간적차치)화혈압주야절률.용다인소선성회귀분석래학정MPI적독립상관인소.결과 MPI＞0.47조화≤0.47조상비,MPI고조적24h화일간평균수축압、24 h、일간화야간평균서장압、24h、일간화야간수축압부하、24h、일간화야간서장압부하급수축압신봉균현저고우MPI저조(균P＜0.05),이평균진실수축압화서장압、야간평균수축압、서장압신봉、야간수축압화서장압교일간하강적백분비량조간차이균무통계학의의(균P＞0.05).다인소회귀분석현시,야간평균서장압(β=0.285,P=0.005)、일간수축압부하(β=0.397,P＜0.001)여MPI독립상관;기타여MPI독립상관적인소위좌심실중량지수(LVMI)화이첨판배측벽서장조기운동봉속도(Em).결론 동태혈압수평화혈압부하적증가반수좌심실MPI적승고.
Objective To explore the relationship between ambulatory blood pressure and myocardial performance index (MPI) in hypertensive patients.Methods A total of 76 hospitalized patients with untreated hypertension from January to June 2013 were recruited.They received the examinations of office blood pressure,24 h ambulatory blood pressure and echocardiography.MPI was determined by the following formula:MPI =(isovolumic contraction time + isovolumic relaxation time) /ejection time.Based upon left ventricular MPI,they were divided into two groups of MPI ＞0.47 (n =38) and MPI ≤0.47 (n =38).The mean levels of office blood pressure,ambulatory blood pressure,blood pressure load,morning blood pressure surge (early morning blood pressure minus the lowest night-time blood pressure) and noctumal blood pressure changes were compared between two groups.And the determinants of MPI were identified by multivariate regression analysis.Results As compared to those with MPI ≤0.47,patients with MPI ＞ 0.47 had higher 24 h and daytime systolic blood pressures,24 h,daytime and nighttime diastolic blood pressures,24 h,daytime and nighttime systolic blood pressure loads,24 h,daytime and nighttime diastolic blood pressure loads and morning systolic blood pressure surges (all P ＜ 0.05).No inter-group differences existed in the mean levels of office blood pressure,nighttime systolic blood pressure,morning diastolic blood pressure surge,nocturnal systolic or diastolic blood pressure changes (all P ＞ 0.05).Multivariate regression analysis showed that nocturnal diastolic blood pressure (β =0.285,P =0.005) and daytime systolic blood pressure load (β =0.397,P ＜ 0.001) were independently associated with MPI.And other factors independently associated with MPI were left ventricular mass index (LVMI) and early diastolic mitral annular velocity (Em).Conclusion The increases of blood pressure level and blood pressure load are associated with an elevation of left ventricular MPI.