动态血压监测指导腹膜透析患者高血压治疗的临床观察  

CLINICAL OBSERVATION OF HYPERTENSION TREATMENT FOR PERITONEAL DIALYSIS PATIENTS ASSESSED AND GUIDED BY DYNAMIC BLOOD PRESSURE MONITORING

作　　者：钟小仕[1] 刘岩[1] 李青[1] 卢智[1] 

机构地区：[1]广州市红十字会医院,广东广州510220

出　　处：《现代医院》2004年第8期22-24,共3页Modern Hospitals

摘　　要：目的　探讨动态血压监测指导腹膜透析患者高血压治疗的意义。方法　使用非侵入性的动态血压监测仪监测 34例腹膜透析 (CAPD)合并有高血压的患者 ,通常从早上 9:0 0开始每 30分钟记录 1次血压 ,共监测 2 4小时。结果　所有病人 2 4小时的平均血压是 14 5 6 / 91 3mmHg ,39 6 %收缩压记录超过 15 0mmHg ,4 8 7%的舒张压记录超过 90mmHg。糖尿病肾病患者 (12例 )平均血压是 15 7 3/ 88 8mmHg ,5 8 5 %的收缩压记录和 4 4 6 %的舒张压记录超过 15 0 / 90mmHg。平均血压、心率和血压负荷白天和夜间没有显著性差异。结论　大多数的CAPD患者伴有高血压的病人其血压控制不佳 ,糖尿病患者血压控制情况更差。大多数CAPD患者血压 2 4小时节律性消失 ,白天和夜间高血压控制不佳并没有区别 ,使用动态血压监测仪评估血压可以指导降压治疗和增加降压达标。Objective To investigate the effect of hypertension treatment for peritoneal dialysis patients assessed and guided by dynamic blood pressure (BP) monitoring. Methods We monitored the BP of 34 hypertensive continuous ambulatory peritoneal dialysis (CAPD) patients. BP monitoring, using a noninvasive dynamic BP monitor, began in 9:00am and continued every 30 min for 24 h. Results The mean BP of all patients over 24h was 145.6/91.3 mmHg. In these, 39.6% of systolic BP readings exceeded 150 mmHg and 48.7% of diastolic readings exceeded 90 mmHg. The mean BP of diabetic patients was 157.3/88.8 mmHg, 58.5% of systolic BP readings and 44.6% of diastolic readings exceeded 150/90 mmHg. Mean BP, heart rates, and BP loads were not different between daytime or nighttime. Conclusion Hypertension is not properly controlled in most CAPD patients; diabetic patients fare even worse in control of hypertension, most patients do not preserve the circadian rhythm of BP and there is no difference in adequacy of hypertension control during the day or at night; assessment of hypertension with dynamic BP monitoring helps guide therapy and control of hypertension.

关 键 词：动态血压监测 腹膜透析 高血压 节律性 血压控制 

分 类 号：R544.1[医药卫生—心血管疾病] R459.5[医药卫生—内科学]