临界性高血压患者昼夜血压变化的流行病学特征研究  

Epidemiologic features of diurnal blood pressure variation in borderline hypertension patients

作　　者：张金华[1] 刘爱军[1] 孙涛[1] 马驰骋[1] 刘爱华[1] 

机构地区：[1]济南市第四人民医院(泰山医学院第二附属医院)内科,山东省济南市250031

出　　处：《中国临床康复》2003年第18期2540-2541,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的研究临界性高血压患者昼夜血压变化,探讨该人群的流行病学特点。方法选取50例临界性高血压患者,配带无创性携带式血压监测仪,分M1(9:00～20:00),M2(21:00～5:00),M3(6:00～8:00)3个时间段连续监测24h血压。结果①24h平均血压(134±13)/(91±8)mmHg,白昼平均舒张压(93±9)mmHg及夜间血压平均值(125±19)/(84±11)mmHg比正常人明显增高(P<0.001),而白昼收缩压平均值与正常人无显著差异(P>0.05);②M1及M3时段收缩压舒张压均值明显高于M2(P<0.001);③24h最高、最低收缩压舒张压差值较大,犤分别为(177～109)/(103～53)mmHg犦;④舒张压负荷值均>10%(M354.7%,M149.3%,M222.1%)。结论①临界高血压患者昼夜血压变化较大,随测血压较难做出正确诊断;②由于昼夜血压波动范围较大(脉压值增大),易致心、脑、肾等靶器官损害,因此应重视对临界高血压的及早控制。Aim To study the diurnal blood pressure (BP) variation in the patien ts with borderline hypertension and to explore the features of epidemiology in thi s population.Methods Fifty patients with borderline hypertension,36 males and 14 females with an average age of(52±11)years, were taken to monitor 24-hour BP with no-damaged portable BP monitor.The monitor course was divided into three p eriods including M1(9:00-20:00),M2(21:00-5:00),M3(6:00-8:00).Results ①The 24 -hour mean blood pressure (MBP) [(134±13) /(91±8)mmHg, daytime mean diastolic blood pressure (DBP) [(93±9)mmHg], and nighttime MBP [(125±19)/(84±11)mmHg] of patients with borderline hypertension were significantly higher than those of normotensive controls (P< 0.001). No significant difference in daytime mean sys tolic blood pressure(SBP) was found between the hypertensive patients and normot ensive controls (P >0.05).②MBP in M1 and M3 was significantly higher than that in M2 (P< 0.001).③The difference between Max SBP and Min SBP [(177-109)mmHg]an d the difference between Max DBP and Min DBP[(103-53)mmHg] were significant. ④ DBP load values were 54.7%in M3 period, 49.3%in M1 period, and 22.1%in M2 per iod, which were all more than 10 %. Conclusion ①BP of the patient with borderl ine hypertension varies markedly in 24 hours. It is different to make a proper d iagnosis just by measuring BP at any moment.②Because 24-hour BP fluctuates gre atly (the value of pulse pressure is enlarged), target-organs such as heart, br ain and kidney are easy to be damaged. Therefore, borderline hypertension should claim attention and be controlled as soon as possible.

关 键 词：临界性高血压 昼夜血压变化 诊断 流行病学特征 血压测定 

分 类 号：R544.1[医药卫生—心血管疾病]