区分原发性高血压患者不同节律类型的研究  

Study on distinction of different types of rhythms in patients with essential hypertension

作　　者：柯漫 李君荣 KE Man;LI Jun-rong(Electrocardiographic Room, Zhenjiang Third People’s Hospital, Zhenjiang 212000, China)

机构地区：[1]镇江市第三人民医院心电图室,212000 [2]江苏大学医学院流行病学与卫生统计学教研室

出　　处：《中国现代药物应用》2017年第23期6-7,共2页Chinese Journal of Modern Drug Application

摘　　要：目的探讨区分不同节律类型原发性高血压方法 ,以指导临床合理选择降压药和给药时间。方法 95例原发性高血压患者,采用24 h动态血压监护仪对所有患者进行24 h动态血压监测(ABPM)分析。分析患者的节律构成[杓型(DH)、超杓型(UDH)、非杓型(NDH)、反杓型(ADH)],并观察比较不同节律类型患者的24 h收缩压平均值(24 h MSBP)、24 h舒张压平均值(24 h MDBP)、白昼收缩压平均值(dMSBP)、白昼舒张压平均值(dMDBP)、夜间收缩压平均值(nMSBP)、夜间舒张压平均值(nMDBP)、收缩压夜间下降率(SBPF)、舒张压夜间下降率(DBPF)。结果 95例患者中,正常节律(杓型节律)患者19例,占20%;异常节律患者76例,占80%,其中超杓型19例、非杓型30例、反杓型27例。不同节律类型患者的dMDBP、nMSBP、nMDBP、SBPF、DBPF比较差异具有统计学意义(P<0.05)。进一步采用SNK法两两比较,任意两种节律类型患者的nMSBP、nMDBP、SBPF、DBPF比较差异均具有统计学意义(P<0.05)。结论 nMSBP、nMDBP、SBPF及DBPF均能较好地区分不同节律类型高血压。Objective To investigate the method of distinguishing different types of rhythms in patients with essential hypertension,so as to guide rational selection of antihypertensive drugs and administration time.Methods A total of95patients with essential hypertension were analyzed with24h ambulatory blood pressure monitoring(ABPM)by24h ambulatory blood pressure monitor.Rhythm constitution[dipper hypertension(DH)and ultra dipper hypertension(UDH),non dipper hypertension(NDH),anti dipper hypertension(ADH)]was analyzed,and observation and comparison were made on patients with different types of rhythm of24h mean systolic blood pressure(24h MSBP),24h mean diastolic blood pressure(24h MDBP),daytime mean systolic blood pressure(dMSBP),daytime mean diastolic blood pressure(dMDBP),nocturnal mean systolic pressure(nMSBP),nocturnal mean diastolic blood pressure(nMDBP),systolic blood pressure fall rate(SBPF),diastolic blood pressure fall rate(DBPF)at night.Results Among95patients,19patients were normal rhythm(dipper rhythm),accounting for20%;76patients were abnormal rhythm,accounting for80%,including19cases of super dipper type,30cases of non dipper type,and27cases of anti dipper type.Patients with different types of rhythms had statistically significant difference in dMDBP,nMSBP,nMDBP,SBPF and DBPF(P<0.05).Further SNK analysis showed that there was statistically significant difference in nMSBP,nMDBP,SBPF and DBPF between two types of rhythms(P<0.05).Conclusion nMSBP,nMDBP,SBPF and DBPF can better distinguish between different rhythm types of hypertension.

关 键 词：原发性高血压 动态血压监测 非杓型高血压 

分 类 号：R544.11[医药卫生—心血管疾病]