白大衣高血压的发生率及其与左室肥厚的关系  

Prevalence of white coat hypertension and its effect on left ventricular hypertrophy

作　　者：黄建凤[1] 吴海英[1] 谢晋湘[1] 刘力生[1] 

机构地区：[1]中国医学科学院阜外心血管病医院高血压诊治中心,北京100037

出　　处：《中华全科医师杂志》2004年第6期358-360,共3页Chinese Journal of General Practitioners

摘　　要：目的　探讨确诊高血压患者中白大衣高血压 (WCH)的发生率及白大衣效应与左室肥厚的关系。方法　入选诊室舒张压水平在 95～ 114mmHg( 1mmHg =0 133kPa)的高血压患者 2 2 4例 ,监测其 2 4h动态血压 ,并进行心电图、超声心动图、血清脂质和血糖等检查。结果　 2 2 4例中WCH的发生率为 10 3%。 1级高血压患者中WCH发生率最高 ( 19 4 % ) ,2级次之 ( 10 1% ) ,3级最低( 1 6 % ) ,趋势P <0 0 1。WCH患者左室质量明显低于持续性高血压患者 (P <0 0 5 )。在收缩压 (或舒张压 )水平已经确定的情况下 ,均未发现收缩期 (或舒张期 )白大衣效应与左室肥厚相关。结论在确诊高血压患者中 ,WCH的发生多见于年轻女性、轻型高血压患者。WCH患者发生左室肥厚的危险性低于持续性高血压患者 ,白大衣效应与左室肥厚无明显相关 。Objectives To investigate the frequency of white coat hypertension (WCH) in all patients with hypertension (HT) and its effect on left ventricular hypertrophy (LVH).Methods A total of 224 patients (with an average age of 51 years, 155 males) with seated diastolic blood pressure of (95～114) mm Hg in clinic were recruited into this study. Their blood pressure was monitored dynamically for 24 h with non-invasive ambulatory method at the same day, and M-mode bi-dimensional echocardiography, electrocardiograph, determinations of serum levels of lipid and glucose were also performed for them. ResultsOverall, 10.3% of HT patients were classified as WHT, with the highest in the grade 1 HT patients (19.4%), 10.1% in the grade 2 HT and 1.6% in the grade 3 HT ( P <0.01). As compared with those with sustained HT, proportion of those with LVH in WCH was significantly lower, with left ventricular mass of (186±10) g vs (216±4) g, P <0.05. No significant correlation was observed between WCH and LVH at a given level of systolic or diastolic blood pressure during daytime by two-way analysis of variance. Conclusions WCH was more frequent in younger female mild hypertensive patients. Risk for LVH in WCH was less than for those with sustained HT. Furthermore, the white coat effect did not significantly associated with LVH, suggesting that it could be a benign condition.

关 键 词：高血压患者 WCH 左室肥厚 发生率 白大衣高血压 白大衣效应 舒张压 水平 结论 情况 

分 类 号：R541.3[医药卫生—心血管疾病]