| 刘力松,华琦,刘荣坤,杨峥.24小时平均脉压和诊所脉压对高血压病患者左室结构的影响[J].中国医学影像技术,2003,19(5):595~598 |
| 24小时平均脉压和诊所脉压对高血压病患者左室结构的影响 |
| Impact of Twenty-Four-Hour Mean Pulse Pressure and Office Pulse Pressure on Left Ventricular Structure of Patients with Essential Hypertension |
| 投稿时间：2003-02-19 |
| DOI： |
| 中文关键词: 脉压 左室结构 左室肥厚 |
| 英文关键词: Pulse pressure (PP) Left ventricular structure Left ventricular hypertrophy (LVH) |
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| 中文摘要: |
| 目的 探讨并比较24小时平均脉压和诊所脉压对高血压病患者左室结构的影响。 方法 选择433名初诊的轻~中度高血压病患者,所有入选病例测量非同日3次诊所血压,进行24小时动态血压监测和超声心动图检查。①根据24小时平均脉压水平分为4组,即A组:24h PP＜40mmHg;B组:40mmHg≤24h PP＜50mmHg;C组:50mmHg≤24h PP＜60mmHg;D组:24h PP≥60mmHg。②根据诊所脉压水平分为4组,即A组:CPP＜40mmHg;B组:40mmHg≤CPP＜50mmHg;C组:50mmHg≤CPP＜60mmHg;D组:CPP≥60mmHg。③根据左室重量指数(left ventricular mass index,LVMI)分为左室肥厚组和无左室肥厚组。结果 24小时收缩压、24小时平均脉压、诊所收缩压和诊所脉压均与LVMI显著相关(r＝0.339、0.279、0.221、0.155,P<0.01),并且24小时血压参数与LVMI的相关性明显强于诊所血压参数;收缩压和脉压均表现为左室肥厚组显著高于无左室肥厚组(P<0.001),而舒张压在各组之间无显著性差异(P>0.05);与左室结构正常组比较,向心性肥厚组的平均年龄最大(53.3±8.7 vs 48.1±8.6,P<0.001),而且高血压病史最长(72.4±107.8 vs 32.1±55.2,P<0.01)。 结论 脉压升高是高血压病患者左室肥厚及左室结构异常的重要危险因素;与诊所脉压比较,24小时平均脉压更能反映高血压靶器官损害的程度。 |
| 英文摘要: |
| Objective To investigate and compare the impact of twenty-four-hour mean pulse pressure and office pulse pressure on left ventricular structure of patients with essential hypertension. Methods All the cases initially untreated subjects with mild to moderate essential hypertension were involved in this study. All subjects underwent 24-hour ambulatory blood pressure monitoring and echocardiography. ①Patients were divided into four groups according to their 24-hour mean pulse pressure scale, group A: 24h PP＜40mmHg; group B: 40mmHg≤24h PP＜50mmHg; group C: 50mmHg≤24h PP＜60mmHg; group D: 24h PP≥60mmHg. ②They were divided into four similar groups according to their office pulse pressure level, group A: CPP＜40mmHg; group B: 40mmHg≤CPP＜50mmHg; group C: 50mmHg≤CPP＜60mmHg; group D: CPP≥60mmHg. ③Patients were further divided into LVH and non-LVH group according to their LVMI degree. Results 24-hour systolic blood pressure, 24-hour mean pulse pressure, office systolic blood pressure, office pulse pressure were all significantly associated with LVMI (r＝0.339,0.279,0.221,0.155, P<0.01), and the correlation of 24-hour blood pressure parameters was greater than that of office blood pressure parameters. SBP and PP were markedly higher in LVH group than in non-LVH group (P<0.001), whereas DBP had no significance between the groups (P>0.05). Compared with normal group, concentric hypertrophy group had the highest average age (53.3±8.7 vs 48.1±8.6, P<0.001) and longest history of hypertension (72.4±107.8 vs 32.1±55.2, P<0.01). Conclusion The increase of pulse pressure was an important risk factor of LVH and LV structure abnormalities. 24-hour mean pulse pressure provided a more precise estimate of target organ damage upon hypertention than office pulse pressure. |
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