【摘要】 目的探讨原发性高血压患者血压昼夜节律及夜间血压与阵发性心房颤动(房颤)的相关性,并探讨其他危险因素对阵发性房颤的影响。方法选择原发性高血压患者411例,其中阵发性房颤组159例,窦性心律组252例,所有患者采集病史、体格检查、行动态血压、常规生化等检查。结果阵发性房颤组非杓型血压比例(96.2%vs83.7%)、夜间收缩压[(132.23±16.50)mm Hg vs(122.38±17.70)mm Hg,1 mm Hg=0.133kPa]、夜间脉压[(62.74±16.67)mm Hg vs(50.83±14.52)mm Hg]明显高于窦性心律组(P<0.01)。单因素相关分析显示,非杓型血压(r=0.191,P<0.01)、夜间收缩压(r=0.254,P<0.01)、夜间脉压(r=0.353,P<0.01)与阵发性房颤呈正相关;调整年龄、血脂、餐后2h血糖、24h血压、昼间血压等危险因素后,二分类logistic回归分析显示,非杓型血压、夜间收缩压升高、年龄是阵发性房颤的独立危险因素。结论非杓型血压、夜间收缩压升高是原发性高血压患者阵发性房颤的独立危险因素,与阵发性房颤发生密切相关。更多还原

【Abstract】 Objective To study the relation of blood pressure circadian rhythm and nighttime blood pressure with paroxysmal atrial fibrillation(PAF)in essential hypertensive patients and the effect of other risk factors on PAF.Methods Four hundred and eleven essential hypertensive patients were divided into PAF group(n=159)and sinus rhythm(SR)group(n=252).Their medical histories were collected.The patients underwent physical examination,ambulatory blood pressure measurement,and routine biochemical tests.Results The prevalence of non-dipper blood pressure was significantly higher in PAF group than in SR group(96.2%vs 83.7%,P<0.01).The nighttime systolic blood pressure and nighttime pulse pressure were significantly higher in PAF group than in SR group(132.23±16.50 mm Hg vs 122.38±17.70 mm Hg,62.74±16.67 mm Hg vs50.83±14.52 mm Hg,P<0.01).Univariate correlation analysis showed that non-dipper blood pressure,nighttime systolic blood pressure and nighttime pulse pressure were positively related with PAF(r=0.191,r=0.254,r=0.353,P<0.01).After adjustment for age,blood lipid,postprandial 2hblood glucose,24 hblood pressure,daytime blood pressure,binary logistic regression analysis showed that non-dipper blood pressure,elevated nighttime systolic blood pressure and age were the independent risk factors for PAF in essential hypertensive patients.ConclusionNon-dipper blood pressure and elevated nighttime systolic blood pressure are the independent risk factors for PAF and are thus closely related with PAF in essential hypertensive patients.更多还原