妊娠期高血压和原发性高血压患者的动态血压分析

Ambulatory blood pressure monitoring in patients with pregnancy-induced hypertension and essential hypertension

目的探讨妊娠期高血压病患者的血压波动规律,为高血压预防筛查高危人群,更为临床降压治疗提供帮助。方法采用美国Suntech公司产的OscAr-2无创性便携式动态血压(ABP)记录仪,分别监测年龄相匹配的妊娠期高血压病患者(A组)、血压正常孕妇(B组)和原发性高血压患者(C组)的血压进行比较。结果 A组患者与C组患者各指标比较:夜间平均收缩压(125.91±4.35,119.93±7.01)、平均舒张压(81.93±1.36,75.91±4.44)差异均有统计学意义;A组夜间负荷有所下降(收缩压负荷54.05±15.53,舒张压负荷53.94±15.57),夜间C组血压负荷明显下降(收缩压负荷37.57±17.89,舒张压负荷29.44±14.34),A组患者夜间血压下降率<10%,昼夜节律消失,呈"非杓型"曲线;C组与B组血压夜间下降率>10%,昼夜节律存在,曲线呈"杓型"。A、C两组各指标与B组相应比较差异均有统计学意义。结论妊娠期高血压波动规律不同于原发性高血压,依据24小时动态血压监测结果为妊娠期高血压疾病的临床降压治疗可提供更好帮助。

Objective To study the dynamic fluctuation of blood pressure in pregnant women with gestational hypertension, provide an experimental base for the screening of high risk populations and clinical antihypertensive therapy. Methods The ambulatory blood pressure monitors was used to monitor the blood pressure of pregnant women with gestational hypertension （group A）, pregnant women with normal BP （group B） and pregnant women with primary hypertension（ group C）. Results Between the group A and C, the difference in nighttime systolic average BPs [ （ 125.91 ± 4.35 ） mm Hg vs. （ 119.93 ± 7.01 ） mm Hg ] and nighttime diastolic average BPs [ （ 81.93 ± 1.36 ）mm Hg, （ 75.91 ± 4.44 ） mm Hg ] were statistically significant（ P 〈 0.05）;the nighttime blood pressure load in group A went down slightly[ nighttime systolic blood pressure load （54.05 ± 15.53）mm Hg, nighttime diastolic blood pressure load （53.94± 15.57）mm Hg] ,whereas they went down apparently in group C [ （ 54.05 ± 15.53 ） mm Hg and （ 29.44 ± 14.34 ） mm Hg ]. The rate of nighttime blood pressure dropping in group A was less than 10% , the circadian rhythm of blood pressure disappeared, from dipper to a non-dipper pattern;while the rate of BP drooping in group B and C was more than 10% , circadian rhythm blood pressure could be founded, dipper pattern. As compared with group B, each index of group A and C were different, and the differ- ence was significant. Conclusion The dynamic fluctuation of blood pressure in pregnant women with gestational hyper- tension has its special characteristic ; the 24-hour ambulatory blood pressure monitoring will provide a base for the clinical antihypertensive therapy in patients with gestational hypertension.