老年心功能不全患者血压昼夜节律的变化及其临床意义

摘要

目的 观察老年心功能不全患者24h动态血压昼夜节律的变化,探讨动态血压监测在老年心功能不全患者病情评估中的价值.方法 将108例老年心功能不全患者根据纽约心脏病协会(NYHA)心功能分级进行准确分级并记录,同时选取同期83例有基础心脏病但无心功能不全的老年患者作为对照组,分别予24h动态血压监测(24 hABPM),比较各组的动态血压参数.结果 与对照组相比,老年心功能不全患者中血压昼夜节律消失的比例明显升高,且心功能Ⅲ、Ⅳ级患者昼夜节律消失的发生率明显高于心功能Ⅱ级患者(均P ＜0.05).结论 老年心功能不全患者血压昼夜节律消失的发生率增高,并与心功能不全的严重程度相关.%Objective To observe the circadian rhythm of blood pressure in elderly patients with heart failure and evaluate the role of ambulatory blood pressure monitoring in heart failure. Methods One hundred and eight elderly patients with heart failure were collected and the cardiac function of these patients were assessed according to New York Heart Association ( NYHA). Eight three cases, in which patients with underlying heart disease had no heart failure, were selected as the controls. Then 24 h ambulatory blood pressure monitoring (24 h ABPM)was performed and several blood pressure parameters in different groups were analyzed. Results In elderly patients with heart failure, the incidence of circadian thythm disappearance was significantly increased (P<0. 05). Furthermore, the incidence of rhythm disappearance in patients with cardiac function Ⅲ or Ⅳ was higher than that in patients with cardiac function Ⅱ (P < 0. 05 ). Conclusion The incidence of abnormal blood pressure rhythm is increased in elderly patients with heart failure, which is correlated with the severity of heart failure. Ambulatory blood pressure monitoring can be used as an indicator of the severity of heart failure.