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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。
Objective To investigate the correlation between home-based blood pressure variability (HBPV) and left ventricular strain rate and Tei index in patients with essential hypertension. Methods From September 2012 to May 2014, 233 eligible patients underwent self-monitoring of blood pressure and heart color ultrasound for 7 days. HBPV is expressed as the standard deviation (s) of the mean daily systolic pressure for the last 6 consecutive days. According to HBPV tertile, subjects were divided into low variability group (79 cases), medium variability group (76 cases) and high variability group (78 cases). Results Compared with the hypervariable group, the SRe and SRa in the apical, middle and basal ganglia in the low and middle variant groups were significantly increased and the SRs were significantly decreased (P <0.05, P <0.01). Compared with the middle variant group, the SRe was significantly increased in the apical SRe, the middle segment and the SRa in the low variant group, and the SRs in the apex and basal segment were significantly decreased (P <0.05, P <0.01). The Tei index (0.41 ± 0.06) was significantly higher in the high variant group than in the low and middle variant group (0.38 ± 0.07), significantly higher than that in the low variant group (0.32 ± 0.07), the difference was statistically significant (P <0.05). HBPV was negatively correlated with apical, middle and basal segments SRe and SRa, and positively correlated with SRs and Tei index (P <0.01). Conclusion HBPV in patients with essential hypertension is closely related to left ventricular strain rate and Tei index.