高血压合并糖尿病患者家庭自测血压所需天数和读数  

Days of Measuring and Times of Readings Needed for Home Blood Pressure Monitoring in the Assessment of Blood Pressure in Hypertensive Patients with Diabetes Mellitus

作　　者：盛长生[1] 崔艳[1] 陈寒萼[1] 樊旺祥[1] 陈歆[1] 黄绮芳[1] 李燕[1] 王继光[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院上海市高血压研究所,上海200025

出　　处：《中华高血压杂志》2010年第4期344-348,共5页Chinese Journal of Hypertension

基　　金：上海市卫生局青年科研项目

摘　　要：背景家庭自测血压有助于高血压患者的血压管理,但目前尚不清楚需要连续测量几天时间,每次需要测量几个读数,才能准确评估血压水平。目的在高血压合并糖尿病患者中,探讨在家中测量血压时需要连续测量的天数和每次测量的读数。方法在上海市的5个社区卫生服务中心,选择血压未得到控制(收缩压≥140 mm Hg或舒张压≥90 mm Hg)且合并糖尿病的高血压患者,使用经过验证的HEM-7051电子血压计(日本欧姆龙公司),在家中连续测量血压6 d,每天早晚各取5个读数。结果109名高血压患者按照方案完成了研究,其中男性39(35.8%)名,年龄(60.4±5.8)岁。自第1天到第6天,每天早上的家庭自测收缩压与舒张压均显著低于家庭测压前1天的诊室血压(P<0.01)。分早上与晚上,计算前3 d收缩压/舒张压15个读数的均值、前2 d 10个读数的均值、第1天5个读数的均值与整个测量期6 d 30个读数的均值的相关系数,前3 d大于前2 d(早上,0.97/0.98比0.95/0.96,P=0.06/0.01;晚上,0.98/0.97比0.95/0.95,P<0.01/0.06),显著大于第1天(早上,0.97/0.98比0.85/0.89,均P<0.01;晚上0.98/0.97比0.83/0.87,均P<0.01)。将每个患者6 d测量期间每天早上与晚上的5个血压读数看作独立样本,计算前3个或前2个读数的均值或第1个读数与5个读数均值的相关系数,结果显示,测量3次血压的相关系数大于2次(0.99/0.99比0.98/0.97,均P<0.01)和1次(0.99/0.99比0.93/0.92,均P<0.01)。结论在高血压合并糖尿病患者中,要获得可靠的家庭血压,至少需要连续测量3 d,早晚测量,各取3个读数。Background Home blood pressure（HBP） monitoring might play a role in the management of hypertension.However,the optimal schedule of measuring remains unclear.Objective We investigated how many consecutive days and how many readings on each occasion would be appropriate for the assessment of blood pressure at home in hypertensive patients with diabetes mellitus.Methods HBP monitoring was performed in uncontrolled hypertensive patients with diabetes mellitus recruited from 5 community health centres in Shanghai.HBP was measured at home for 6 consecutive days,with 5 readings each in the morning and in the evening.The Omron HEM-7051 blood pressure monitor was used at home as well as in the outpatient clinic.Results One hundred and nine subjects completed HBP monitoring according to the protocol.Of 109 subjects,39（35.8%） were men.The average age（SD） was（60.4±5.8）years old.The morning systolic/diastolic blood pressures measured at home on each of the 6 days were lower than the blood pressures measured in the clinic on the day before HBP monitoring（P〈0.01）.The correlation coefficients were calculated for the morning and evening blood pressure readings separately,and for the mean of total 30 blood pressure readings in the 6 consecutive days with that of 15,10,and 5 readings during the first 3 and 2 days and the first day,respectively.The correlation coefficients were greater for 3 days than for 2 days（morning,0.97/0.98 vs 0.95/0.96,P=0.06/0.01;evening 0.98/0.97 vs 0.95/0.95,P0.01/0.06）,and for the first single day（morning,0.97/0.98 vs 0.85/0.89,P〈0.01 for both;0.98/0.97 vs 0.83/0.87,P〈0.01 for both）.We then pooled blood pressure readings measured in the morning and evening in the whole 6-day period,and calculated the correlation coefficients for the mean of 5 reading on each occasion with that of the first 3 and 2 readings and the first reading.The correlation coefficients were greater for 3 than for 2 readings（0.99/0.99 vs 0.98/0.97,P0.01 for both）,and for the first single reading�

关 键 词：高血压 糖尿病 家庭自测血压 家庭疾病管理 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]