不同动态血压参数在高血压靶器官损害中的应用价值

The clinical valuation of the different ambulatory blood pressure monitoring parameters in hypertensive target organs damage

目的:探讨不同动态血压参数对评价高血压靶器官损害的临床应用价值。方法:对100例原发性高血压患者进行24h动态血压监测(Ambulatoryblood pressure monitoring,ABPM)及相关靶器官的检查,根据有无靶器官损害分为单纯高血压组(高血压组)和高血压伴靶器官损害组(靶器官损害组),分别对2组间及靶器官损害组内的动态血压参数进行统计学分析。结果:(1)靶器官损害组的夜间平均收缩压、夜间平均脉压、白天收缩压负荷、夜间收缩压负荷均明显高于高血压组(P均<0.05)。(2)伴3个靶器官损害组的血压昼夜节律异常概率、24 h平均收缩压、夜间平均收缩压、白天收缩压负荷、夜间收缩压负荷均明显高于伴1个靶器官损害组(P均<0.05);伴3个靶器官损害组的24 h平均舒张压、白天平均舒张压、夜间平均舒张压、夜间收缩压负荷、夜间舒张压负荷均明显高于伴2个靶器官损害组(P均<0.05);伴2个靶器官损害组的24 h平均舒张压、白天平均舒张压均明显低于伴1个靶器官损害组(P均<0.05),但24 h平均脉压却明显高于伴1个靶器官损害组(P均<0.05)。结论:ABPM参数中有关收缩压的参数对临床判断高血压靶器官损害及其程度最有价值。

Objective：To explore the clinical values ofdifferent ambulatory blood pressure monitoring（ABPM）parameters to hypertensive target organs damage. Methods：100 primary hypertensive patients were picked out to perform ABPM,and divided into isolated hypertension group （hypertension group）and hypertensive organs damaged group（organs damaged group）accordingtothe condition with or without target organs damage. The ABPM parameters between the two groups and among the organs damaged group were valuated with statistic methods. Results：（1）nighttime average systolic blood pressure,nighttime average pulse pressure,daytime and nighttime systolic blood pressure load in target organs damaged group were higher than those in hypertension group （P0.05）.（2）The ratio of abnormal day-night rhythm,24 h average systolic blood pressure,nighttime average systolic blood pressure,daytime and nighttime systolic blood pressure load were higher in the patients with 3 target organs damage than those in ones with 1 target organ damage （P0.05）. 24 h average diastolic blood pressure,daytime and nighttime average diastolic blood pressure,nighttime systolic and diastolic blood pressure load were higher in the patients with 3 target organs damage than those in ones with 2 target organs damage （P0.05）.24 h and daytime average diastolic blood pressure were lower in the patients with 2 target organs damage than those in ones with 1 target organ damage（P0.05）,but 24 h average pulse pressure was higher in the patients with 2 target organs damage than those in ones with 1 target organ damage（P0.05）. Conclusion：ABPM parameters about systolic blood pressure are the most valuable ones in clinical judging hypertensive target organs damage and their extent.