生化指标及动态血压检测对隐匿性高血压的临床诊断  

Clinical Diagnosis for Masked Hypertension by Biochemical Indexes and Ambulatory Blood Pressure Monitoring

作　　者：何文一[1] 邓国兰[1] 张丹丹[2] 

机构地区：[1]重庆医科大学附属第一医院心血管内科,重庆400016 [2]南昌大学医学院,南昌330006

出　　处：《基因组学与应用生物学》2017年第6期2326-2331,共6页Genomics and Applied Biology

基　　金：国家重点专科建设项目(2011年):慢性病早期康复;筛查;心电监测及健康管理的规范技术推广项目(cstc-2015jcsf10012)资助

摘　　要：为了探讨脂代谢、尿酸等生化指标及动态血压监测对隐匿性高血压诊断的价值,本研究分别选取来我院诊断的隐匿性高血压患者91例,真性高血压患者120例,正常人群100例为隐匿性高血压组、真性高血压组和对照组,考察各组脂代谢、尿酸生化指标及动态血压数据的临床特点。与对照组相比,真性高血压组患者的血清总胆固醇(serum total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL)、载脂蛋白B(apolipoprotein B,APOB)均显著增高,隐匿性高血压组患者LDL明显增高;真性高血压组所有动态血压参数均高于对照组;隐匿性高血压组患者的白天、夜间、24 h平均收缩压(systolic blood pressure,SBP)和夜间、24 h平均舒张压(diastolic blood pressure,DBP)均明显高于对照组;3组的尿酸水平无明显差异。Spearman直线相关分析显示,TC、HDL、APOB与动态血压数据显著相关。研究表明,脂代谢、尿酸生化指标及动态血压的联合检测能更准确地评估隐匿性高血压,为隐匿性高血压的诊断与心血管疾病的预防提供参考;同时提示我们,脂代谢异常的人群罹患高血压疾病的风险更大,需特别注意隐匿性高血压的早期筛查。In order to investigate the value of ambulatory blood pressure monitoring and biochemical indicators such as the lipid metabolism and uric acid in the diagnosis of masked hypertension, this study selected 91 masked hypertension patients, 120 true hypertensive patients, and 100 normal people who were diagnosed in our hospital as masked hypertension group, true hypertension group and the control group, respectively. The clinical characteristics of the lipid metabolism, uric acid biochemical index and ambulatory blood pressure data of each group were observed. Compared with the control group, the serum total cholesterol （TC）, low density lipoprotein （LDL）, and apolipoprotein B （APOB） in true hypertensive patients were significantly increased. The LDL of masked hypertension patients was also obviously elevated; all ambulatory blood pressure parameters in true hypertension group were higher than those in the control group; the average systolic blood pressure （SBP） of masked hypertension patients during daytime, nighttime and 24 hours, and the average diastolic blood pressure （DBP） during nighttime and 24 hours were obviously higher than those of the control group. There was no significant difference of uric acid levels among three groups. The Spearman linear correlation analysis showed that the TC, HDL, and APOB wereremarkably correlated with ambulatory blood pressure data. This study indicated that the combined detection of lipid metabolism, uric acid biochemical indexes and dynamic blood pressure could assess the masked hypertension more accurately and provide references for the diagnosis of masked hypertension and the prevention of cardiovascular disease; meanwhile, it also reminded us that people with abnormal lipid metabolism would be at higher risk of hypertension, so we should pay more attention to early screening of masked hypertension.

关 键 词：生化指标 动态血压监测 隐匿性高血压 临床诊断 

分 类 号：R544.1[医药卫生—心血管疾病]