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目的观察老年高血压病患者昼夜血压节律对左房容积(LAV)和左室容积(LVV)的影响。方法根据夜间血压下降百分率将126例老年高血压病患者分为年龄、性别匹配的两组,夜间血压下降率﹤10%为非杓型组(A组),≥10%为杓型组(B组)。受试者给予24h动态血压监测结合超声心动图检查,观察并比较2组患者的血压昼夜节律及左房容积和左室容积的改变。结果 (1)A组24h收缩压均值和舒张压均值、白天收缩压均值和舒张压均值、夜间收缩压均值和舒张压均值水平高于B组(均P﹤0.05)。(2)A组的左室收缩末期容积(ESV)、左室舒张末期容积(EDV)较B组增大(均P﹤0.05),但LAV、左心房容积指数(LAVI)两组间差异无统计学意义(均P﹥0.05)。结论非杓型血压节律的老年高血压患者较杓型血压节律者更易导致左心室容积增大。
Objective To observe the effects of diurnal blood pressure rhythm on left atrium volume (LAV) and left ventricular volume (LVV) in elderly hypertensive patients. Methods One hundred and sixty-two elderly patients with essential hypertension were divided into two groups according to the percentage of nocturnal decline in blood pressure. The rate of nocturnal hypotension was <10% in non-dipper group (group A) and> 10% in dipper group group). Subjects were given 24h ambulatory blood pressure monitoring combined with echocardiography, observed and compared two groups of patients with circadian rhythm of blood pressure and left atrial volume and left ventricular volume changes. Results (1) 24h mean systolic pressure and diastolic pressure, mean systolic pressure and mean diastolic pressure, mean systolic pressure at night and mean diastolic pressure in group A were significantly higher than those in group B (all P <0.05). (2) The left ventricular end - systolic volume (ESV) and left ventricular end - diastolic volume (EDV) in group A were significantly higher than those in group B (all P <0.05), but there was no significant difference between LAV and left atrial volume index (LAVI) Statistical significance (all P> 0.05). Conclusion Elderly hypertensive patients with non-dipper blood pressure rhythm more easily lead to increased left ventricular volume than those with dipper blood pressure rhythm.