原发性高血压患者短时收缩压变异性观察  

A Cmparision of Short-term Systolic Blood Pressure Variability in Essential Hypertensive Patients

作　　者：卓德华[1] 曹宸赟[1] 潘扬[1] 关敬树[1] 唐丽萍[1] 曹承吉[1] 徐守如[1] 龚兰生[2] 

机构地区：[1]上海市宝山中心医院心内科,201900 [2]上海市瑞金医院,上海市高血压研究所,上海200025

出　　处：《高血压杂志》2001年第1期8-10,共3页Chinese Journal of Hypertension

摘　　要：目的　研究原发性高血压 (EH)短时收缩压变异性 (SSBPV)的变化 ,推测SSBPV在EH上的病生理机制。方法　用无袖带式动态血压仪检测 31例性别和年龄匹配的EH患者的SSBPV ,并与正常组 (n =32 )比较。按静坐、站立、心算、握力、踏车依次进行 ,每组监测 10分钟 ,每 2次心跳采样 1次 ,有效血压记录不少于 30 0点。结果　 (1)EH组与对照组在踏车时的SSBPV较其余的状态差异均显著 (P <0 0 1)。 (2 )对照组中SSBPV依次为握力 >站立 >心算 >静坐 ,且各状态间差异显著 (P <0 0 5 ) ,尤其在站立与静坐间 (P <0 0 1)。 (3)EH组心算与握力时的SSBPV较同组静坐时差异显著 (P <0 0 5 )。 (4 )EH组静坐、站立、心算时的SSBPV较正常组明显升高 (P <0 0 1) ;但握力、踏车时与正常组无差异 (P >0 0 5 )。结论　无论EH患者抑或正常人 ,脑力劳动与等长、等张运动是SSBPV增强的重要因素 ,体位改变对SSBPV的意义尚不能肯定。SSBPV既与收缩压显著升高有关 ,也可独立于收缩压之外。EH较正常人于静坐、站立、心算时SSBPV明显升高 ,但握力、踏车时差异不显著。SSBPV增大是EH一个重要特征 ,主要由于动脉压力反射敏感性减退及阻力小动脉结构重塑所致血管收缩反应性增强 。Objective\ To observe short term systolic blood pressure variability(SSBPV) in essential hypertensive (EH) patients, suspecting the mechanism of the SSBPV of the pathophysiological state in EH. Methods\ SSBPV was evaluated in 31 EH patients matched in sex and age using ambulatory blood pressure device of no cuff type, and compared with age matched normal controls ( n =32). SSBPV was assessed by turns over 10 minuts: quietly sitting,standing, mental arithmetic, isometric handgrip and cycle ergometer test.For each two heartbeat BP was sampling once by ambulatory blood pressure recording instrument. The sampling number should be not is no less than 300 points. Results\ (1) The SSBPV during cycle ergometer were significantly higher both in EH and controls than other tests. (2) The SSBPV in the controls group was assessed by following sequences: isometric handgrip>cycle ergometer>mental arithmetic>sitting, and the SSBPV significantly different in each test(\%P\%<0 05). The differences were most pronounced between the standing and the sitting(\%P\%<0 01). (3) The SSBPV of mental arithmetic and isometric handgrip were significantly higher than those in sitting(\%P\%<0 05) in EH. (4) The SSBPV of sitting and standing and mental arithmetic were significantly higher in EH patients than those in controls(\%P\%<0 01). The SSBPV in isometric handgrip and cycle ergometer showed little difference in EH(\%P\%>0 05). Conclusions\ Intellectual work, isometric exercise and isotonic exercise were the most important daily performances to increase the SSBPV. There was a significant increase in SSBPV in sitting and standing and mental arithmetic with EH, but little change was found in isometric handgrip and cycle ergometer compared with controls. Increased SSBPV may be an important feature in EH.

关 键 词：原发性高血压 血压变异性 并发症 治疗 

分 类 号：R544.1[医药卫生—心血管疾病]