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目的探讨原发性高血压患者单纯收缩期高血压、单纯舒张期高血压血压负荷值与SMI的相关关系。方法选择同步ABPM及DCG的高血压患者120例(A组单纯收缩期高血压60例,B组单纯舒张期高血压60例)。血压负荷值:轻度负荷(10.1%～40.0%)、中度负荷(40.1%～80.0%)。根据24h血压负荷值把患者分轻度(A1组、B1组各30例)、中度(A2组、B2组各30例),分别中度组与轻度组比较、在同等程度血压负荷下B组和A组比较;各组间分白昼、夜间,各组夜间与白昼进行比较、中度组与轻度组(A组间、B组间)以及同等程度血压负荷下B组和A组间(夜间组、白昼组)分别进行比较,比较不同组间ST段压低程度、持续时间及发作次数。结果24h血压负荷值各组比较:轻度负荷下B1与A1组比较差异有统计学意义(P<0.05),其它各组差异均有统计学意义(P<0.01);血压负荷值各组夜间与白昼比较:轻度负荷时A1组夜间与白昼比较差异无统计学意义,B1组差异有统计学意义,其它各组差异均有统计学意义。结论单纯收缩期、舒张期原发性高血压病患者SMI的发作频率、ST段压低程度、持续时间都随着24h、白昼、夜间血压负荷值增高而增加,特别是中度负荷以上,且在同等程度负荷下夜间尤甚,舒张压比收缩压更为显著。
Objective To investigate the correlation between SMI and blood pressure load in isolated systolic hypertension and simple diastolic hypertension in patients with essential hypertension. Methods A total of 120 hypertensive patients with synchronous ABPM and DCG were selected (group A, 60 cases of isolated systolic hypertension and group B, 60 cases of simple diastolic hypertension). Blood pressure load values: light load (10.1% ~ 40.0%), moderate load (40.1% ~ 80.0%). According to the 24h blood pressure load, the patients were divided into mild (30 cases in group A1 and group B1) and moderate (30 cases in group A2 and group B2), respectively. Compared with moderate group and mild group, Group B was compared with Group A; the groups were divided into daytime, nighttime, nighttime and daylight, and moderate and mild (group A, group B) and group B and group A (Nocturnal group, day group) were compared between the different groups were compared ST-segment depression, duration and number of seizures. Results 24h blood pressure load in each group compared: light load B1 and A1 group, the difference was statistically significant (P <0.05), the other groups were statistically significant differences (P <0.01); blood pressure load in each group at night Compared with the daylight: There was no significant difference between the night group and the daylight when the A1 group was lightly loaded, the difference between the B1 group and the other groups was statistically significant. Conclusions The frequency of episodes of SMI, the degree of ST depression and the duration of SMI in simple systolic and diastolic patients with essential hypertension are both increased with the increase of blood pressure load at 24h, daytime and nighttime, especially above moderate load, Under the same degree of load especially at night, diastolic blood pressure is more significant than systolic blood pressure.