摘要
目的 探讨原发性高血压患者血压晨峰对心脏重构以及心血管事件的影响。方法2006年2月至2009年1月在本院就诊的高血压病患者中，按就诊顺序连续入选386例高血压患者，根据动态血压检测结果，分为晨峰组（146例）和非晨峰组（240例），均同步记录24h动态血压和动态心电图，观察24h动态血压参数，24h动态心电图检出的房性、室性心律失常及ST段偏移；行超声心动图检测左室质量指数（LVMI）、左房内径等指标。结果晨峰组与非晨峰组LVMI分别为（119±21）g／m^2和（93±12）g／m^2（P〈0．01）；左房内径分别为（46±11）mm与（38±10）mm（P〈0．05）；房性早搏检出率分别为98．6％与84．2％（P〈0．05）；房性心动过速检出率分别为54．1％与20．8％（P〈0．01）；心房颤动检出率分别为24．0％与0（P〈0．01）；室性早搏和室性心动过速的检出率分别为79．5％与57．9％（P〈0．05）和6．8％与2．5％（P〈0．05）；检出ST段水平型压低率分别为33．6％与13．8％（P〈0．01）。两组左室肥厚的检出率分别为67．1％与30．4％（P〈0．01）。53．2％的心律失常和57．6％的ST段压低发作出现在清晨6：00～8：00。相关分析表明，清晨血压和血压晨峰升高与对应时域ST段压低呈正相关。结论与无血压晨峰的高血压病患者相比，具有血压晨峰的高血压患者左心室肥厚更显著，心律失常和心肌缺血更常见，且多出现在清晨。
Objective To investigate effects of morning blood pressure surge （MBPS） on cardiac remodeling and cardiovascular events in patients with essential hypertension. Methods Totally, 386 patients with essential hypertension were recruited into the study, 146 with MBPS and 240 without it based on their dynamic blood pressure monitoring. All the patients were monitored by 24-hour ambulatory blood pressure measurements, 24-hour Holter electrocardiography and echocardiography for dynamic blood pressure, left ventricular mass index （LVMI）, left atrial dimension （LAD）, atrial and ventricular arrhythmias and ST depression, and so on. Results Compared with non-MBPS group, patients with MBPS had significantly higher incidence of left ventricular hypertrophy （LVH）, enlargement of left atrial dimension, cardiac arrhythmias and myocardial isehemia detected, with LVMI [ （119 ±21 ） g/m2 vs. （93 ± 12） g/m2, P〈0.01], LAD [（46±11） mmvs. （38±10） mm, P〈0.05], LVH （67.1% vs. 30.4%, P〈0.01）, atrial premature beats （98.6% vs. 84.2%, P 〈0.05）, atrial taehycardia （54.1% vs. 20. 8% , P 〈 0. 01 ） , atrial fibrillations （ 24. 0% vs. 0, P 〈 0.01 ） ; ventricular premature beats and ventrieular tachycardia （79.5% vs. 57.9% , P 〈 0. 05, and 6. 8% vs. 2. 5% , P 〈 0. 05 ） , ST-segment depression （33.6% vs. 13.8% , P 〈 0. 01 ） , respectively. And, 53.2 percent of cardiac arrhythmia and 57.6 percent of ST-segment depression occurred at six to eight o＇clock in the morning. Blood pressure early in the morning and MBPS associated with ST-segment depression at the corresponding time （ P 〈 0. 05 ）. Conclusions LVH is more significant, cardiac arrhythmias is severer and myocardial isehemia is more common in hypertensive patients with MBPS than that in those of non-MBPS.
出处
《中华全科医师杂志》
2011年第2期97-100,共4页
Chinese Journal of General Practitioners
关键词
高血压
血压
心律失常
心肌缺血
Hypertension
Blood pressure
Arrhythmia
Myocardial ischemia
