高血压患者24小时动态血压监测的临床价值

A study on the clinical significauce of ambulatory blood pressure monitoring in senile and presenile patients with essential hypertension

采用无创性动态血压监护仪对老年期、老年前期高血压患者和对照组共２１６例进行２４小时动态血压观察。结果显示，２４小时血压均值在高血压组明显高于对照组。老年高血压患者和相应对照组均显示２４小时血压有明显波动，且老年患者的血压波动幅度较中青年患者高。多数夜间血压明显低于白天血压。对照组和患者中多数具有双峰双谷或近似双峰双谷的昼夜血压变化曲线规律。对照组的夜间血压均值＜１６．０／１０．７ｋＰａ（１２０／８０ｍｍＨｇ），因此提出若老年人夜间血压超过１６．０／１０．７ｋＰａ者，应进一步观察血压变化或随访。本组尚有２６例（１６．４％）高血压患者的夜间血压均值＜１４．７／９．３ｋＰａ（１１０／７０ｍｍＨｇ），提出对这部分患者不宜夜间给降压药。

Abstract One hundred and fifty-nine senile and presenile patients with essential hypertension and 57 normal senile and presenile subjects were assessed with 24-hour noninvasive ambulatory blood pressure(BP) monitoring.The results showed :24-hour average value of BP in the hypertensive groups was higher than that of normal groups(P<0.01).The range of BP fluctuation in the senile patients was greater than that in the middle age patients and the average value of their BP were lower during sleep in the night.Most of the patients had curves of duple peaks and duple valleys or somewhat similar curves showing day and night BP fluctuation.After comparison,it was shown that the diastolic pressure readings in the senile patients were lower than those of the presenile patients in the same stage of essential hypertension.Because of the average value of BP in the normal groups was less than 16/10.7kpa(120/80mmHg) during sleep,senile subjecfs with BP>16/10.7kpa in the night must be examined further or followed up so that the diagnosis of hypertension will not be missed. An average value of BP during sleep<14.7/9.3kpa(110/70mmHg)was found in 16.4% of the patients with essential hypertension (mostly in senile patients) in this study.It is suggested that antihypertensive drugs should not be given to these patients in the night.