动态血压监测指标指导临床治疗老年高血压的意义  

Guiding value of ambulatory blood pressure monitoring index in clinical prevention and treatment of elderly hypertensive population

作　　者：张永军[1] 徐尚银[1] 吴祝霞[1] 樊紫青 周文娇 姚应水 ZHANG Yong-jun;XU Shang-yin;WU Zhu-xia;FAN Zi-qing;ZHOU Wen-jiao;YAO Ying-shui(Department of Electrophysiological,Yijishan Hospital of Wannan Medical College,WuHu 241001,China;School of Public Health,Wannan Medical College,WuHu 241001,China)

机构地区：[1]皖南医学院弋矶山医院电生理科,芜湖241001 [2]皖南医学院公共卫生学院,芜湖241001

出　　处：《中华疾病控制杂志》2019年第7期785-789,共5页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金项目(81541071);安徽省科技厅公益性技术应用研究联动计划项目(1704f0804047)~~

摘　　要：目的通过监测高血压患者的动态血压,分析其对临床老年高血压人群防治工作的应用价值。方法监测2017年12月-2018年12月期间519例高血压患者的动态血压,按照60岁为分界点,分成≥60岁老年组264例,<60岁中青年对照组255例,对血压、血压昼夜节律、脉压、血压变异系数、血压负荷值、平均心率、晨峰血压等系列指标进行临床分析。结果老年组动态血压昼夜节律异常发生率为76. 5%,与对照组比较,舒张压、舒张压负荷值、脉压、24 h平均心率、收缩压变异系数、24 h舒张压变异系数、晨峰舒张压等指标两组间均有差异(均有P <0. 05),且老年组中不同血压节律类型的24 h收缩压、夜间收缩压、夜间舒张压、夜间脉压、白天收缩压负荷值、夜间收缩压负荷值、24 h收缩压变异系数、24 h舒张压变异系数等指标均有差异(均有P <0. 05)。结论动态血压监测指标对老年高血压人群临床合理用药有一定的指导价值。Objective To study the application value of dynamic monitoring of blood pressure in the prevention and treatment of elderly hypertension. Methods 519 hypertensive patients from December 2017 to December 2018 were monitored with ambulatory blood pressure monitoring,and were divided into the elderly group(≥60 years old,264 cases) and the control group(< 60 years old,255 cases). The results of ambulatory blood pressure monitoring in two groups were analyzed,which inclued the circadian rhythm of blood pressure,blood pressure,pulse pressure,coefficient of variation of blood pressure,blood pressure load value,average heart rate and morning blood pressure surge. Results The incidence of abnormal circadian rhythm of ambulatory blood pressure in the elderly group was 76. 5%. Compared with the control group,there were differences in the indexes of diastolic blood pressure( DBP),diastolic blood pressure load value( DBPLV),pulse pressure( PP),24 h average heart rate( 24 h AHR),systolic blood pressure coefficient of variation( SBPCV),24 h diastolic blood pressure coefficient of variation( 24 h DBPCV) and morning diastolic blood pressure surge( MDBPS) between the two groups( all P < 0. 05).There were differences in 24 h systolic blood pressure( 24 hSBP),night systolic blood pressure( nSBP),night diastolic blood pressure( n DBP),night pulse pressure( nPP),day systolic blood pressure load value( dSBPLV),ninght systolic blood pressure load value( nSBPLV),24 h SBPCV,24 h d DBPCV and other indicators among different blood pressure types in the elderly group( all P < 0. 05). Conclusion Ambulatory blood pressure monitoring indicators have important guiding value for the prevention and treatment of elderly hypertension.

关 键 词：高血压 动态血压监测 昼夜节律 治疗 

分 类 号：R544.1[医药卫生—心血管疾病]