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目的探讨高血压病患者脉压随年龄变化的趋势及其与左心室肥厚、左室舒张功能的关系。方法将127例高血压病患者按年龄由小到大分为三组,比较不同年龄组的血压及超声心动图检查结果,分析收缩压、舒张压、脉压、左室心肌重量指数(LVM I)及左室舒张期充盈率。结果Ⅰ组收缩压、舒张压、脉压呈轻度增高,LVM I无明显改变而左心室舒张功能都已有下降(P<0.01);Ⅱ组收缩压、舒张压、脉压与I组比较有增高(P<0.05),LVM I与I组比较明显增高,左心室舒张功能与I组比较明显降低(P<0.01);Ⅲ组的收缩压与I、Ⅱ组比较有增高(P<0.01),舒张压急剧下降,而脉压却急剧上升,LVM I与I、Ⅱ组比较增高明显,左心室舒张功能与I、Ⅱ组比较降低亦明显(P<0.01)。结论高血压病患者随着年龄的增长,脉压呈加速上升趋势,脉压升高更易导致左心室肥厚和左心室舒张功能的减退。
Objective To investigate the trend of pulse pressure in patients with essential hypertension with age and its relationship with left ventricular hypertrophy and left ventricular diastolic function. Methods A total of 127 hypertensive patients were divided into three groups according to age. Blood pressure and echocardiography were compared among different age groups. Systolic blood pressure, diastolic blood pressure, pulse pressure, left ventricular myocardial mass index (LVM I) And left ventricular diastolic filling rate. Results In group Ⅰ, the systolic blood pressure, diastolic blood pressure and pulse pressure increased slightly, while the left ventricular diastolic function had no significant change in LVM I group (P <0.01). The systolic blood pressure, diastolic blood pressure and pulse pressure in group Ⅱ were significantly lower than those in group Ⅰ (P <0.05), LVM I increased significantly compared with I group, and left ventricular diastolic function decreased significantly compared with I group (P <0.01); systolic blood pressure of group III increased compared with I and II groups (P <0.01) ), Diastolic blood pressure decreased sharply, but pulse pressure increased rapidly. LVM I increased significantly compared with I and II groups, and left ventricular diastolic function decreased significantly compared with I and II groups (P <0.01). Conclusions With the increase of age, the pulse pressure is accelerating upward in hypertensive patients. Increased pulse pressure may lead to the decrease of left ventricular hypertrophy and left ventricular diastolic function.