老老年H型高血压患者动态血压参数特点分析  

Correlation between ambulatory blood pressure monitory parameters and H hypertension in very elderly patients

作　　者：张予[1] 魏艺[1] 胡元会[1] 宋庆桥[1] 褚瑜光[1] 吴华芹[1] 李可[2] 李偲偲[2] 

机构地区：[1]中国中医科学院广安门医院心内科,北京市100053 [2]北京中医药大学针灸学院

出　　处：《中国心血管病研究》2015年第4期350-354,共5页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金，国家中医药管理局国家中医临床研究基地业务建设科研专项课题

摘　　要：目的 研究老老年H型高血压患者动态血压特征.方法 选取2013年5月至2014年4月中国中医科学院广安门医院住院患者共197例,年龄均≥80岁;根据患者血浆Hcy水平,分为H型高血压组（147例）和非H型高血压组（50例）;均行动态血压监测,比较两组患者动态血压参数的差异.结果 丙氨酸转氨酶H型高血压组为（24.70±8.10）mmol/L,高于非H型高血压组的（20.14±12.55）mmol/L;夜间脉压H型高血压组为（67.02±15.90）mm Hg,高于非H型高血压组的（60.26±13.45）mm Hg;夜间平均动脉压H型高血压组为（85.91±11.27）mm Hg,高于非H型高血压组的（79.64±11.55）mm Hg;夜间收缩压负荷H型高血压组为33.46±33.28,高于非H型高血压组的22.32±30.76;夜间收缩压下降率H型高血压组为（-1.89±10.88）％,低于非H型高血压组的（4.25±8.98）％;夜间舒张压下降率H型高血压组为（0.25±11.39）％,低于非H型高血压组的（6.21±10.77）％;两组比较差异均有统计学意义（P均＜0.05）.Spearman相关性分析显示,丙氨酸转氨酶、夜间脉压、夜间平均动脉压、夜间收缩压负荷、夜间收缩压下降率、夜间舒张压下降率与H型高血压存在相关性.经二元Logistic回归分析显示,夜间APP、夜间收缩压下降率为老老年H型高血压的独立影响因素.结论 老老年H型高血压患者与非H型高血压患者动态血压参数之间存在差异,其中夜间平均动脉压、夜间收缩压下降率与H型高血压关系最密切,两者或许可以作为老老年H型高血压的指征之一.在临床实践中应重视老老年夜间血压的监测,从而有效地进行诊疗,改善心脑血管病预后及生活质量.Objective To study the characteristics of ambulatory blood pressure monitory parameters of H hypertension and the relationship between them of very elderly patients. Methods Choose 197 subjects of China Academy of Traditional Guang＇anmen hospital in the period of May 2013 to April 2014, whose aged were 80 years old or eider, based on the level of HCY, the subjects were divided into 2 groups, one was H type hypertensive group, 147 eases, the other was non H type hypertensive group, 50 cases. Every one of them should be tested by ambulatory blood pressure monitor, and then compare the difference between the two groups. Results ALT level： H type hypertensive group （24.70±8.10）mmol/L〉non H type hypertensive group （20.14±12.55）mmol/L. Night pulse pressure level： H type hypertensive group （67.02±15.90）mm Hg〉non H type hypertensive group （60.26± 13.45）mm Hg. Night average pulse pressure level： H type hypertensive group （85.91±11.27）mm Hg〉non H type hypertensive group （79.64±11.55）mm Hg. Night systolic blood pressure load： H type hypertensive group （33.46±33.28） 〉non H type hypertensive group （22.32±30.76）. Night systolic blood pressure decline rate： H type hypertensive group（1.89±10.88）%〈non H type hypertensive group（4.25±8.98）%. Night diastolic blood pressure decline rate： H type hypertensive group（0.25±.39）%〈non H type hypertensive group（6.21±10.77）%. All of the above P〈0.05, there were significant differences between them. Spearman correlation analysis indicated that there were significent correlation between H hypertension and ALT, night pulse pressure, night average artery pulse pressure, night systolic blood pressure decline rate, night diastolic blood pressure decline rate. Logistic regression analysis indicated that night average artery pulse pressure, night systolic blood pressure decline rate was independent effective factors of H hypertension of very elderly patients. Conclusion There are significant differences of ambulat

关 键 词：老老年 H型高血压 动态血压监测 

分 类 号：R544.1[医药卫生—心血管疾病]