【作者】 陈歆悦；

【导师】 白小涓；

【作者基本信息】 中国医科大学 ， 内科学， 2010， 硕士

【摘要】 目的探讨血压异常节律变化类型对老年单纯收缩期高血压患者心脏功能和结构的影响。方法对94名老年单纯收缩期高血压患者进行24小时动态血压监测,同时行心脏超声多普勒检查。根据血压类型进行分组,观察不同血压类型的规律性变化,并将非杓型及反杓型血压类型与心脏功能和结构的各项指标进行分析。结果1、24小时动态血压结果表明老年单纯收缩期高血压患者异常血压类型占93%；其中,非杓型血压类型占58%,反杓型血压类型占35%。2.心脏功能和结构指标观察,反杓型组与非杓型组比较：主动脉根部内径(mm)(31.36±5.12,26.57±4.49)、室间隔厚度(mm)(11.21±2.50,9.66±1.13)、左室后壁厚度(mm)(9.76±1.41,9.02±1.02)、每搏量(ml)(45.05±17.36,61.10±16.24)组间具有显著统计学差异(p<0.01)；射血分数(%)(46.26±12.66,55.21±10.53)、左室质量(g)(224.89±43.32,192.72±61.02)、左室质量指数(g／m2)(124.13±22.54,105.39±32.62)组间具有统计学差异(p<0.05)。结论老年单纯收缩期高血压患者,血压异常节律变化是引起心脏靶器官损害的重要因素,其中反杓型血压节律变化使心脏功能和结构受损更为显著。更多还原

【Abstract】 ObjectiveThe aim of this study is to investigate the effects of non-dipper and reverse dipper blood pressure patterns on the cardiac structure and function in elderly systolic hypertensive patients.Methods94 elderly systolic hypertensive patients were evaluated with echocardiography and ambulatory 24-hour blood pressure monitoring,84 patients with non-dipper blood pressure pattern and reverse dipper blood pressure pattern are included into our further research. Tissue Doppler-derived systolic and diastolic parameters were compared between non-dipper group and reverse dipper group. All the patients received fixed antihypertensive drug therapy for at least 3 months prior to the evaluation. ResultsAbnormal blood pressure patterns were found in 93% elderly systolic hypertensive patients, including 55 non dipper blood pressure patterns (58%) and 22 reverse blood pressure patterns (35%). Compared with non-dipper blood pressure pattern, reverse dipper patients had significant difference for aortic diameter(mm) (31.36±5.12, 26.57±4.49)、left ventricular septum thickness(mm) (11.21±2.50,9.66±1.13)、left ventricular posterior wall thickness(mm) (9.76±1.41,9.02±1.02)、stroke volume(ml) (45.05±17.36,61.10±16.24) (p<0.01). There is difference between reverse dipper group and non-dipper group for ejection fraction (%)(46.26±12.66,55.21±10.53)、left ventricular mass(g)(224.89±43.32,192.72±61.02)、left ventricular mass index(g/m2) (124.13±22.54,105.39±32.62)ConclusionBlood pressure rhythm is one of the most important effect factors on target organ in elderly systolic hypertensive patients. Reverse dipper blood pressure patterns influence more on left ventricular structure and functions than non-dipper group.更多还原