老年人清晨高血压对靶器官损害的临床观察

Clinical Observing on the Effects of Morning Blood Pressure to Target Organs Among the Old Hypertension Patients

目的通过监测老年原发性高血压患者清晨高血压(morning blood pressure,MBP),检测清晨高血压峰(morning blood pressure surge,MBPS)对心脑肾靶器官的影响,制定科学的护理方案。方法对70例老年高血压患者利用动态血压测定仪进行血压分析,分为血压晨峰组36例与非晨峰组34例;依据超声心动图计算心肌左室质量指数(LVMI),尿微量清蛋白及肌酐并计算2者比值(ACR),以颅脑磁共振或CT筛查脑梗死。结果晨峰组与非晨峰组的BNP、LVMI间差异有统计学意义(P<0.05);2组的ACR比较差异亦有统计学意义(P<0.05);晨峰组出现脑梗死24例,非晨峰组出现脑梗死14例,晨峰组与非晨峰组脑梗死发生率间差异有统计学意义(P<0.05)。结论老年高血压患者MBPS与心脑肾靶器官损伤密切相关,因此应根据血压变化调整服药时间,减少血压晨峰对靶器官的损害。

Objective To observe the effect of morning blood pressure surge （MBPS） to target organ in the old hypertension patients. Science nursing project be planned. Methods According to the blood pressure with ambulatory blood pressure monitor, 70 patients were divided into MBPS group （n = 36） and non - MBPS group （n = 34）. Left ventricular mass index （LVMI） were measured by echocardiography. Albumen creatinine ratio （ACR） were measured. Cerebral infarction were measured by CT or MR. Results LVMI and ACR of MBPS were higher than those of non - MBPS （ P 〈 0. 05 ）. The incidence of cerebral infarction of MBPS group was higher than that of non - MBPS group （ P 〈 0. 05）. Conclusion MBPS has closely correlation with target organ damage （TOD）, so the nursing project and time of taking medicine be adjusted according to the MBPS, it should be reduced the damage of target organ.