慢性阻塞性肺病急性加重期动态血压监测的临床意义  

Clinical significance of ambulatory blood pressure monitoring in patients with chronic obstructive pulmonary disease exacerbation

作　　者：寿松涛[1] 柴艳芬[1] 王鑫[1] 崔书章[1] 刘洪斌[2] 

机构地区：[1]天津医科大学总医院急救中心重症监护病房,300052 [2]天津医科大学总医院动态血压检查室

出　　处：《中国急救医学》2003年第8期537-538,共2页Chinese Journal of Critical Care Medicine

摘　　要：目的　观察慢性阻塞性肺病 (COPD)急性加重期病人 2 4h动态血压变化规律 ,探讨影响其血压变化的因素。方法　 6 2例COPD急性加重期病人根据动脉血气分析结果分成低PO2 正常PCO2 组 (A组 )、低PO2 高PCO2 组 (B组 )、低PO2 低PCO2 组 (C组 )和正常PO2 高PCO2 组 (D组 )。各组病人均进行 2 4h动态血压监测和血糖、皮质醇、T3 等测定 ,将检测结果在各组间进行统计学分析 ,观察不同组病人动态血压及其昼夜变化规律与动脉血气分析和血皮质醇及T3 水平变化的关系。结果　B组和D组病人收缩压、舒张压和皮质醇浓度明显升高 (与其他各组比较P <0 0 5 ) ,T3 明显降低 ,而且皮质醇浓度与收缩压和PCO2 呈明显正相关。此外 ,动态血压昼夜变化规律为 :B组非勺型血压曲线发生率最高 ,以下依次为D组、C组和A组。结论　PCO2 增高可能是COPD急性加重期病人血压升高和非勺型血压曲线增加的主要原因。Objective To observe 24-hour ambulatory blood pressure variability in patients with chronic obstructive pulmonary disease exacerbation,and find out the facts that had an effect on blood pressure.Methods Sixty-two cases were divided into low arterial oxygen pressure and normal partial pressure of carbon dioxide(A group),low arterial oxygen pressure and high partial pressure of carbon dioxide(B group),low arterial oxygen pressure and low partial pressure of carbon dioxide(C group),and normal arterial oxygen pressure and high partial pressure of carbon dioxide (D group) based on arterial blood gas analysis.Ambulatory blood pressure monitoring,blood sugar,cortisol and T 3 were measured in all the patients.The results were analysed between different groups.Results SBP,DBP and cortisol all increased in the patients of B and D groups(P<0 05).In addition the circadian rhythm of blood pressure variability showed that the highest incidence of non-dippers appear in B group.Conclusion High partial pressure of carbon dioxide had blood pressure increased and non-dippers of blood pressure curve changed.

关 键 词：慢性阻塞性肺病急性加重期 动态血压 昼夜节律 动脉血气 

分 类 号：R563.9[医药卫生—呼吸系统]