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目的探讨高血压病患者血压节律变化与左心室及颈动脉重构的关系。方法选择原发性高血压患者149例,根据动态血压(ABPM)检测结果将昼夜血压节律曲线分为杓型和非杓型2组,将这2组患者的ABPM、超声心动图(UCG)及颈动脉超声的参数进行比较。结果非杓型组比杓型组24 h SBP、24 h DBP、nSBP、nDBP、IVST、LVPWT、LAD、LVMI、A/E、IMT、D、RI及颈动脉斑块检出率明显增高(P<0.05,P<0.01),而PSV和EDV则显著下降(P<0.05)。左室构型上两者也有明显差异(P<0.05,P<0.01),非杓型组向心性重构或左室肥厚者明显多于杓型组。结论非杓型动态血压节律较杓型节律的高血压患者有更严重的心脏及大动脉损害。ABPM、UCG及颈动脉超声对高血压的诊断与治疗,评价预后及判断靶器官损害等方面都有重要的意义。
Objective To investigate the relationship between changes of blood pressure rhythm and remodeling of left ventricle and carotid artery in patients with essential hypertension. Methods A total of 149 patients with essential hypertension were enrolled in this study. The circadian rhythm of blood pressure was divided into two groups based on ABPM: ABPM, echocardiography (UCG) and echocardiography Carotid ultrasound parameters were compared. Results The detection rates of SBP, 24 h DBP, nSBP, nDBP, IVST, LVPWT, LAD, LVMI, A / E, IMT, D, RI and carotid plaques in non-dipper group were significantly higher than those in dipper group <0.05, P <0.01), while PSV and EDV decreased significantly (P <0.05). There was also a significant difference in left ventricular configuration between the two groups (P <0.05, P <0.01). The non-dipper group had more concentric remodeling or left ventricular hypertrophy than the dipper group. Conclusion Non-dipper ambulatory blood pressure rhythm has more severe damage to the heart and aorta than hypertensive patients with dipper rhythm. ABPM, UCG and carotid artery ultrasound diagnosis and treatment of hypertension, evaluate the prognosis and target organ damage and other aspects are of great significance.