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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2016年第1期

页码:

66-069

栏目:

临床研究

出版日期:

2015-09-15

文章信息/Info

Title:

Variability of self-measured blood pressure at home is related to left ventricular strain rate and Tei index in patients with essential hypertensive

作者:

魏 芳¹; 王华亭¹; 刘振东²; 赵颖馨²; 张 华²; 栾 萌²

（1.山东大学附属济南市中心医院心血管内科，山东 济南 250013；
2.山东省医学科学院基础医学研究所，山东 济南 250062）

Author(s):

WEI Fang¹;  WANG Hua-ting¹;  LIU Zhen-dong²;  ZHAO Ying-xin²;  ZHANG Hua²;  LUAN Meng²

(1.Department of Cardiology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong, China；
2.Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, Shandong, China)

关键词:

家庭自测血压; 血压变异性; 应变率; Tei指数

Keywords:

home blood pressure monitoring;  blood pressure variability;  strain rate imaging;  Tei index

分类号:

R544.1

DOI:

-

文献标识码:

A

摘要:

目的 探讨原发性高血压患者家庭自测血压变异性（HBPV）与左心室应变率及Tei指数的相关性。方法 2012年9月~2014年5月对合格入选的233例进行7 d家庭血压自我监测及心脏彩色超声检测。HBPV用最后连续6 d的每日收缩压平均值的标准偏差（s）表示。根据HBPV三分位，将受试者分为低变异性组（79例），中变异性组（76例）和高变异性组（78例）。结果 与高变异组比较，低及中变异组心尖部、中间段、基底段的SRe及SRa显著增高，SRs明显降低，差异有统计学意义（P<0.05，P<0.01）。与中变异组比较，低变异组心尖部SRe、中间段SRe及基底段SRa显著增高，心尖部及基底段SRs明显降低，差异有统计学意义（P<0.05，P<0.01）。高变异组Tei指数（0.41±0.06）显著高于低及中变异组，中变异组（0.38±0.07）显著高于低变异组（0.32±0.07），差异有统计学意义（P<0.05）。HBPV与心尖部、中间段、基底段SRe及SRa呈显著负相关，与SRs及Tei指数呈显著正相关（P<0.01）。结论 原发性高血压患者HBPV与左心室应变率及Tei指数密切相关。

Abstract:

AIM To explore the relationship between the variability of self-measured blood pressure at home (HBPV) and left ventricular strain rate and Tei index in essential hypertensive patients. METHODSFrom September 2012 to May 2014, 233 essential hypertensive patients were enrolled. Seven consecutive days self-measured blood pressure at home, strain rate of left ventricular segments, and Tei index were evaluated in all participations. According to tertile of systolic HBPV, participations were divided into low BPV group (n=79), medium BPV group (n=76) and high BPV group (n=78). RESULTSCompared with those in high BPV group, SRe and SRa of left ventricular apex, middle and basic section in low and medium BPV groups were significantly higher, and SRs of left ventricular apex, middle and basic section were markedly lower (P<0.05, P<0.01). In low BPV group, SRe of left ventricular apex and middle section and SRa of left ventricular basic section were significantly higher, and SRs of left ventricular apex and basic section were markedly lower than those in medium BPV group (P<0.05). Tei index in high BPV group (0.41±0.06) was significantly higher than that in low and medium BPV groups (0.32±0.07 and 0.38±0.07, respectively, P<0.05, P<0.01). Tei index in medium BPV group was significantly higher than that in low BPV group (P<0.05). HBPV was closely correlated with SRe, SRa, SRs of left ventricular apex, middle and basic section and Tei index (P<0.01). CONCLUSIONThe variability of self-measured blood pressure at home is closely correlated with left ventricular strain rate and Tei index in essential hypertensive patients.

参考文献/References

[1]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[2]Liu Z,We F,Zhao Y,et al.Day-by-day variability of self-measured blood pressure at home associated with cold pressor test norepinephrine, and heart rate variability in normotensive to moderate hypertensive[J].Int J Cardiol,2013,168(4):4574-4576.
[3]Liu Z,Zhao Y,Lu F,et al.Day-by-day variability in self-measured blood pressure at home:effects on carotid artery atherosclerosis,brachial flow-mediated dilation, and endothelin-1 in normotensive and mild-moderate hypertensive individuals[J].Blood Press Monit,2013,18(6):316-325.
[4]Mancia G,Fagard R,Narkiewicz K,et al.2013 ESH/ESC Guidelines for the management of arterial hypertension:The Task Force for themanagement of arterial hypertension of the European Society of Hypertension(ESH)and of the European Society of Cardiology(ESC)[J].Eur Heart J,2013,34(28):2159-2219.
[5]Dieterle T.Blood pressure measurement-an overview[J].Swiss Med Wkly,2012,142:w13517.
[6]王志斌，何香芹.超声应变率显像技术评价左心室舒张功能的临床应用进展[J].中华高血压杂志,2010,18(1):1-4.
[7]Tei C,Nishimura RA,Seward JB,et al.Noninvasive Doppler-derived myocardial performance index:correlation with simultaneous measurements of cardiac index:catheterization measurements[J].J Am Soc Echocardiogr,1997,10(2):169-178.
[8]高玉梅，叶 琳，刘振东，等.老年高血压患者家庭自测血压变异性与心率变异性的相关性研究[J].中华老年心脑血管病杂志,2014,16(4):374-376.
[9]中国医师协会高血压专业委员会，中国高血压联盟，中华医学会心血管病分会.家庭血压监测中国专家共识[J].中华高血压杂志,2012,20(6):525-529.
[10]Choi HJ.Blood pressure variability and its management in hypertensive patients[J].Korean J Fam Med,2012, 33(6):330-335.
[11]Dhillon A,Sweet W,Popovic ZB,et al.Association of noninvasively measured left ventricular mechanics with in vitro muscle contractile performance: a prospective study in hypertrophic cardiomyopathy patients[J].J Am Heart Assoc,2014,3(6):e001269.
[12]刘振东，范存芳，路方红，等.甲状腺功能亢进症患者超声心动图左心室应变率与左心室Tei指数的关系[J].中国循环杂志,2011,26(6):208-211.
[13]Hsu PC,Lee WH,Chu CY,et al.The ratio of early mitral inflow velocity to global diastolic strain rate as a useful predictor of cardiac outcomes in patients with atrial fibrillation[J].J Am Soc Echocardiogr,2014,27(7):717-725.
[14]郭 芳，赵颖馨，曹春林，等.老年隐性高血压患者家庭自测血压变异性与颈动脉粥样硬化的相关性[J].中华老年心脑血管病杂志,2013,15(9):937-940.

备注/Memo

备注/Memo:

收稿日期：2014-11-25.
>基金项目：国家自然科学基金项目资助（81470489）；山东省自然科学基金项目资助（2R2014HM098，2R2014HQ042，ZR2012HL46）；山东省医药卫生科技发展计划项目资助（2014WS0312，2014WS0316，2013WS0364，2013WS0176）
通讯作者：刘振东，主任医师，主要从事心血管病研究 Email：zhendongliu876@126.com
作者简介：魏芳，主治医师，硕士生 Email：wf720310@163.com

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更新日期/Last Update: 2015-09-16