【摘要】 目的评估远程家庭血压监测数据与原发性高血压(高血压)患者左心房容积指数(left atrial volume index,LAVI)的相关性及其对高血压患者左心房增大(left atrial enlargement,LAE)的预测价值。方法选取2019年3月至2020年4月于深圳市宝安区人民医院且就诊符合纳入标准的高血压患者218例为研究对象。受试者使用使用家庭血压远程监测设备连续测量血压7 d,计算2～7 d内最大家庭收缩压(home systolic blood pressure,HSBP)、平均HSBP、HSBP标准差(HSBPsd)、HSBP变异系数(HSBPcv),完善超声心动图检查,计算左心室质量指数(left ventricular mass index,LVMI)、LAVI。结果 LAE组最大HSBP、平均HSBP、HSBPsd及HSBPcv均高于非LAE组,差异有统计学意义(P<0.05)。相关性分析发现,最大HSBP(r=0.699,P<0.001)、平均HSBP(r=0.578,P<0.001)、HSBPsd(r=0.590,P<0.001)及HSBPcv(r=0.482,P<0.001)与LAVI呈正相关。多元线性回归分析发现,最大及平均HSBP、HSBPsd、HSBPcv均与LAVI呈独立正相关关系(P<0.05),其中,最大HSBP与LAVI独立相关性最佳。作受试者工作特征(receiver operating characteristic,ROC)曲线分析,当最大HSBP取169.5 mmHg(1 mmHg=0.133 kPa)时,敏感度为78.9%,特异度为82.2%。结论最大HSBP、平均HSBP、HSBPsd及HSBPcv与LAVI呈独立正相关。最大HSBP与LAVI相关性最佳,对LAE具有预测价值。更多还原

【Abstract】 Objectives To assess the correlation between home blood pressure telemonitoring data and left atrial volume index(LAVI)in patients with essential hypertension,and to explore the predictive value of home blood pressure telemonitoring for hypertensive left atrial enlargement(LAE).Methods A total of 218 patients with essential hypertension were included form March 2019 to April 2020 in People′s Hospital of Baoan District for this study.The subjects used the remote sphygmomanometer device to measure blood pressure continuously for 7 days.The maximum home systolic blood pressure(HSBP)during 2-7 day period was taken as the maximum HSBP and the mean HSBP,standard deviation of HSBP(HSBPsd)and coefficient of variation of HSBP(HSBPcv)were calculated.Ultrasonographic investigations were performed to calculate the left ventricular mass index(LVMI)and LAVI.Results The maximum HSBP,mean HSBP,HSBPsd,and HSBPcv of LAE group were significantly higher than those of non-LAE group(P<0.05).The correlation analysis indicated that the maximum HSBP(r=0.699,P<0.001),mean HSBP(r=0.578,P<0.001),HSBPsd (r=0.590,P<0.001) and HSBPcv (r=0.482,P<0.001) positively correlated with LAVI.The multivariate linear regression analysis revealed that the maximum HSBP,mean HSBP,HSBPsd,and HSBPcv independently and positively correlated with LAVI(P<0.05),especially in the maximum HSBP.The maximum HSBP cut-off value for detecting LAE was 169.5 mm Hg(1 mm Hg=0.133 k Pa),based on receiver operating characteristic(ROC)curve analysis with a sensitivity of 78.9% and a specificity of 82.2%.Conclusions The maximum HSBP,mean HSBP,HSBPsd and HSBPcv independently and positively correlated with LAVI.The maximum HSBP gets the best correlation with LAVI,and has predictive value for LAE.更多还原