CAJ | 학술논문

目的：探讨持续性心房颤动（房颤）对原发性高血压患者血压昼夜节律变化的影响。 　　方法：选取2013-01至2014-01我院就诊患者173例，将其分为原发性高血压组（高血压组，n=88），持续性房颤合并原发性高血压组（房颤合并高血压组，n=85例）。分析所有患者基线资料，并用Logistic回归分析影响持续性房颤合并原发性高血压患者的危险因素。 　　结果：与高血压组比较，房颤合并高血压组白天平均舒张压、白天最小收缩压、白天最小舒张压、24 h平均舒张压均显著降低，夜间最大收缩压显著升高及舒张压反杓型比例显著升高（P均<0.05）；两组白天平均收缩压、白天最大收缩压、白天最大舒张压、24 h平均收缩压、夜间平均收缩压、夜间平均舒张压、夜间最大舒张压、夜间最小收缩压、夜间最小舒张压及收缩压反杓型比例差异无统计学意义（P均>0.05）。多因素Logistic回归分析显示，夜间最大收缩压与持续性房颤合并高血压显著相关（比值比=1.038，95%可信区间：1.014~1.062，P<0.01）。 　　结论：持续性房颤可导致原发性高血压患者白天血压显著下降，而夜间血压下降不明显。
목적：탐토지속성심방전동（방전）대원발성고혈압환자혈압주야절률변화적영향。 　　방법：선취2013-01지2014-01아원취진환자173례，장기분위원발성고혈압조（고혈압조，n=88），지속성방전합병원발성고혈압조（방전합병고혈압조，n=85례）。분석소유환자기선자료，병용Logistic회귀분석영향지속성방전합병원발성고혈압환자적위험인소。 　　결과：여고혈압조비교，방전합병고혈압조백천평균서장압、백천최소수축압、백천최소서장압、24 h평균서장압균현저강저，야간최대수축압현저승고급서장압반표형비례현저승고（P균<0.05）；량조백천평균수축압、백천최대수축압、백천최대서장압、24 h평균수축압、야간평균수축압、야간평균서장압、야간최대서장압、야간최소수축압、야간최소서장압급수축압반표형비례차이무통계학의의（P균>0.05）。다인소Logistic회귀분석현시，야간최대수축압여지속성방전합병고혈압현저상관（비치비=1.038，95%가신구간：1.014~1.062，P<0.01）。 　　결론：지속성방전가도치원발성고혈압환자백천혈압현저하강，이야간혈압하강불명현。
Objective: To explore the effect of persistent atrial ifbrillation (AF) on circadian rhythm of blood pressure (BP) in patients with essential hypertension (EH). Methods: A total of 173 EH patients treated in Gansu Provincial Hospital from 2013-02 to 2014-01were studied. The patients were divided into 2 groups: EH group,n=88 and Persistent AF combining EH group,n=85. The baseline information was studied and the risk factors of persistent AF combining EH were investigated by multivariate logistic regression analysis. Results: Compared with EH group, the Persistent AF combining EH group showed decreased average daytime DBP, minimum daytime SBP, minimum daytime DBP and the average 24-hour DBP, while increased maximum nighttime SBP and the percentage of reverse dipper in DBP, allP<0.05. There were no significant differences for the average of daytime SBP, maximum daytime SBP, maximum daytime DBP, the average 24-hour SBP, average nighttime SBP, average nighttime DBP, maximum nighttime DBP, minimum nighttime SBP, minimum nighttime DBP and the percentage of reverse dipper in SBP between 2 groups, allP>0.05. Multivariate logistic regression analysis indicated that the maximum nighttime SBP was obviously related to persistent AF combining EH (OR=1.038, 95 CI 1.014-1.062,P=0.001). Conclusion: Persistent AF may incur daytime BP dropping, such change was not obviously observed for nighttime BP in EH patients.