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目的:观察高血压病患者血压晨峰(morning blood pressure surge,MBPS)与心脏肥大和颈动脉内膜-中膜厚度(IMT)的关系。方法:高血压病患者386例。根据动态血压检测结果,分为晨峰组(146例)和非晨峰组(240例),全部病例同步记录24 h动态血压和动态心电图,观察指标为24 h动态血压参数;超声技术检测左室质量指数(LVMI)、左房内径(LAD)、颈动脉IMT等指标。结果:晨峰组与非晨峰组比较:LVMI分别为(119±21)g/m2和(92±12)g/m2(P<0.01);LAD分别为(46±11)mm与(38±10)mm(P<0.05);颈动脉IMT分别为(1.36±0.24)mm与(0.92±0.18)mm(P<0.01);左室肥厚(LVH)的检出率分别为67%与30%(P<0.01)。结论:与无血压晨峰的高血压病患者比,具有血压晨峰的高血压病患者LVH和颈动脉硬化更显著,心血管重构更显著,左心房内径更大。
Objective: To observe the relationship between morning blood pressure surge (MBPS) and cardiac hypertrophy and carotid intima-media thickness (IMT) in patients with essential hypertension. Methods: 386 patients with hypertension. According to the results of ambulatory blood pressure test, it was divided into morning climax group (146 cases) and non-morning climax group (240 cases). All cases recorded 24-hour ambulatory blood pressure and ambulatory electrocardiogram synchronously. The observation index was 24 h ambulatory blood pressure parameter. (LVMI), left atrial diameter (LAD) and carotid IMT. Results: Compared with non-morning peaked group, LVMI was (119 ± 21) g / m2 and (92 ± 12) g / m2 respectively (P <0.01) (1.36 ± 0.24) mm and (0.92 ± 0.18) mm respectively (P <0.01). The detection rates of left ventricular hypertrophy (LVH) were 67% and 30% respectively % (P <0.01). CONCLUSIONS: Hypertensive patients with peak morning blood pressure have significantly more LVH and carotid atherosclerosis than patients without hypertension at morning peak, cardiovascular remodeling is more pronounced, and the diameter of the left atrium is larger.