老老年人动态血压的监测与分析

The ambulatory blood pressure monitoring analysis in the very elderly

目的通过动态血压监测来探讨老老年人的血压变化特点。方法随机抽取105例年龄60～79岁的老年人和99例年龄≥80岁的老老年人进行24h动态血压监测(ABMP),根据动态血压监测的原始数据分析相关参数,并进行统计学分析。结果 (1)老老年组的高血压患病率(79%)高于老年组(40%),但2组差异无统计学意义(χ2=0.650,P>0.05)。非杓型血压例数(92例)明显多于老年组(68例),但2组异常率比较差异无统计学意义(χ2=2.456,P>0.05)。(2)老老年组的24h平均收缩压(24h-SBP)、白昼平均收缩压(dSBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)、24h平均脉压(24h-PP)、白昼平均收缩压血压负荷值(dSBP/BPL)及夜间平均收缩压血压负荷值(nSBP/BPL)均高于老年组,2组比较,nSBP、24h-PP和nSBP/BPL差异有统计学意义(P<0.01)。(3)老老年组的24h平均舒张压(24h-DBP)、白昼平均舒张压(dDBP)、24h平均脉压指数(24h-PPI)、白昼平均舒张压血压负荷值(dDBP/BPL)及夜间平均舒张压血压负荷值(nDBP/BPL)均低于老年组,2组比较差异无统计学意义(P>0.05)。结论随年龄增大高血压患病率及非杓型血压呈上升趋势,老老年人血压变化特点以收缩压增高、脉压差增大、收缩压血压负荷值明显增加为主。

Objective To explore the special features of ambulatory blood pressure monitoring in the very elderly.Methods The old people aged 65～79years old（n=105）and the very elderly people aged≥80 years old（n=99）were verified by systematic investigation and accepted 24hambulary blood pressure monitoring（ABPM）,T-test and correlation analysis were done then.Results（1）The very elderly group＇s hypertension prevalence rate（79%）was higher than the old age group（40%）,the non-scoop blood pressure example number（92）was higher than the old age group（68）.（2）The very elderly group＇s 24h sys-tolic blood pressure（SBP）,daytime SBP,nighttime SBP,nighttime diastolic blood pressure（DBP）,24h pulse pressure（PP）,daytime and nighttime SBP blood pressure burden were higher than the old age group,two groups had statistically significant differences（P〈0.01）,at nighttime SBP,24hpulse pressure and nighttime SBP blood pressure burden.（3）The very elderly group＇s 24hDBP,daytime DBP,24 h pulse pressure index（PPI）,daytime and nighttime DBP blood pressure burden were lower than the old age group,with no significant differences（P〉0.05）.Conclusion With age increased,the hypertension prevalence rate and the non-scoop blood pressure shows the growing trend,the features of ambulatory blood pressure monitoring in the very elderly include the systolic pressure increasing,24hpulse pressure enlarging and the SBP blood pressure burden raising obviously.