摘要
目的 探讨原发性高血压患者血压变异与左室舒张功能的关系.方法 对2021 年10 月至2022 年1 月我院门诊138 例初诊原发性高血压患者的临床资料进行回顾性分析,根据超声心动图测量平均E/e'结果分两组(舒张功能正常组E/e'＜14、舒张功能降低组E/e'≥14),比较两组间24h动态血压指标结果(血压变异以血压变异系数、平均收缩压及舒张压标准差表示),分析左室舒张功能与血压变异指标及临床生化指标的相关性.结果 左室舒张功能降低组患者的24h收缩压变异系数(24hSBPCV)、24 h收缩压标准差(24hSBPSD)、24 h舒张压变异系数(24hDBPCV)、日间收缩压变异系数(dSBPCV)、日间舒张压变异系数(dDBPCV)、日间收缩压标准差(dSBPSD)、24 h收缩压平均水平(24hSBP)、夜间收缩压平均水平(nSBP)均高于舒张功能正常组,24hDBP、dDBP及nDBP低于舒张功能正常组,差异有统计学意义(P＜0.05).相关性分析提示:24hSBPCV、24hSBPSD、dSBPCV、dSBPSD、24hSBP、nSBP、年龄均与 E/e'呈正相关(r = 0.136、0.182、0.170、0.205、0.195、0.322、0.568,P =0.032、0.004、0.007、0.001、0.022、0.000、0.000);24hDBP、dDBP及nDBP均与E/e'呈负相关(r =-0.322、-0.334、-0.198,P =0.000、0.000、0.020);Logistic回归分析显示:dSBPSD及年龄是左室舒张功能的独立影响因素[OR =3.062(1.314～7.133)、1.094(1.058～1.132)].结论 原发性高血压患者短期血压变异及年龄是左室舒张功能的影响因素.
Abstract
Objective To investigate the relationship between blood pressure variability and left ventricular diastolic func-tion in patients with essential hypertension.Methods A retrospective analysis was conducted on the clinical data of 138 patients with essential hypertension in our outpatient department from October 2021 to January 2022.They were divided into two groups ac-cording to E/e'in echocardiography(ideal left ventricular diastolic function group E/e'＜14 and left ventricular diastolic dysfunc-tion group E/e'≥14).The results of 24-hour ambulatory blood pressure monitoring between the two groups were compared(blood pressure variability was represented by coefficient of variability(CV),standard deviation(SD)of mean systolic blood pressure and standard deviation of mean diastolic blood pressure),the correlation between left ventricular diastolic function,blood pressure var-iability indexes and clinical biochemical indexes were analyzed.Results The coefficient of variability of 24 h systolic blood pres-sure(24hSBPCV),standard deviation of 24 h systolic blood pressure(24hSBPSD),the coefficient of variability of 24 h diastolic blood pressure(24hDBPCV),the coefficient of variability of systolic blood pressure in the day(dSBPCV),the coefficient of varia-bility of diastolic blood pressure in the day(dDBPCV)and standard deviation of systolic blood pressure in the day(dSBPSD),24 h systolic blood pressure(24hSBP)and nighttime systolic blood pressure(nSBP)in left ventricular diastolic dysfunction group were higher than those in ideal diastolic function group,24 h diastolic blood pressure(24hDBP)、daytime diastolic blood pressure(dD-BP)and nighttime diastolic blood pressure(nDBP)in left ventricular diastolic dysfunction group were lower than those in ideal di-astolic function group.The difference were statistically significant(P＜0.05).Correlation analysis:24hSBPCV,24hSBPSD,dSB-PCV,dSBPSD,24hSBP,nSBP and age were all positively correlated with E/e'(r =0.136,0.182,0.170,0.205,0.195,0.322,0.568;P = 0.032,0.004,0.007,0.001,0.022,0.000,0.000),24hDBP,dDBP and nDBP were all negatively correlated with E/e'(r =-0.322,-0.334,-0.198;P =0.000,0.000,0.020),Logistic regression analysis:dSBPSD and age were independent factors of left ventricular diastolic function[OR =3.062(1.314～7.133),1.094(1.058～1.132)].Conclusion Age and short-term blood pressure variabilities are influence factors of left ventricular diastolic function in essential hypertension patients.
维普
万方数据