原发性高血压患者动态血压参数与左心室肥厚的相关性研究

摘要

Objective To explore the correlation between left ventricular hypertrophy (LVH) and dynamic parameters of blood pressure as well as blood pressure variation in patients with essential hypertension (EH). Methods From January to September, 2013, 581 patients with EH were divided into hypertrophy group (n=161) and non-hypertrophy group (n=420) according to the left ventricular mass index (LV-MI). The clinical data, biochemical indexes and dynamic parameters of blood pressure were compared, and the multiple factors regression was used to analyze the risk factors of LVH. Results The incidence of LVH was higher in women than in men (χ2=4.836, P=0.03), the level of blood uric acid was higher in the hypertrophy group than in the non-hypertrophy group (t=-11.540, P<0.001). The clinic systolic blood pressure was higher in the non-hypertrophy group (t=-3.805, P<0.001). There was significantly difference in 24-hour systolic blood pres-sure load, systolic blood pressure drops at night and average systolic blood pressure between two groups (t>2.770, P<0.05). Multi-factor Lo-gistic regression analysis showed that gender (OR=1.674, P=0.044) and 24-hour systolic blood pressure load (OR=1.021, P=0.003) associat-ed with LVH. Conclusion The occurrence of LVH in patients with EH was closely related to the 24-hour systolic blood pressure load, and was higher in women than in men.%目的：探究原发性高血压患者动态血压参数与血压变异和左心室肥厚(LVH)的相关性。方法收集2013年1~9月高血压科患者581例，根据左心室质量指数(LVMI)将患者分为肥厚组(n=161)和非肥厚组(n=420)。比较两组患者的一般临床资料、生化指标和动态血压，并采用多因素回归分析LVH的危险因素。结果女性LVH发生率高于男性(χ2=4.836, P=0.03)，肥厚组血尿酸水平显著高于非肥厚组(t=-11.540, P<0.001)。肥厚组诊室收缩压显著高于非肥厚组(t=-3.805, P<0.001)，两组间24 h收缩压血压负荷、夜间收缩压下降率、平均收缩压有显著性差异(t>2.770, P<0.05)。多因素Logistic回归分析显示，性别(OR=1.674, P=0.044)、24 h收缩压负荷(OR=1.021, P=0.003)与LVH相关。结论原发性高血压患者LVH的发生与24 h收缩压负荷密切相关，并且女性发生率高于男性。