飞行人员早期高血压病动态血压分析及医学鉴定

Application of Ambulatory Blood Pressure Monitoring to Medical Evaluation of Aircrew with Early Hypertension

目的探讨飞行人员早期高血压病诊治更全面的评价方法,为飞行人员早期高血压病诊治及医学鉴定提供依据。方法 32例男性诊室血压(OBP)1级高血压飞行人员,根据动态血压监测(ABPM)24 h血压均值将其分为2组:ABPM高血压组和白大衣高血压组(WCH组),分析其ABPM参数,同期纳入30名健康男性飞行人员作为对照组。结果ABPM高血压组17例,占OBP高血压总数的53.13%。WCH组15例,占OBP高血压总数的46.88%。夜间收缩压下降率(n SBPF)、夜间舒张压下降率(n DBPF)3组间差异无统计学意义。24 h收缩压负荷(24h SBPL)、24 h舒张压负荷(24h DBPL)3组间差异均有显著的统计学意义。结论 ABPM高血压组和WCH组血压仍保持正常的昼夜节律。24h SBPL、24h DBPL是区分3组的较敏感指标。ABPM能更客观地评价飞行人员早期高血压病的病情,可作为飞行人员早期高血压病诊治和医学鉴定的重要参考指标。

Objective To investigate the application of ambulatory blood pressure monitoring（ABPM） to medical evaluation of aircrew with early hypertension. Methods According to the 24-hour mean value of ambulatory blood pressure, 32 aircrews with office hypertension were divided into ABPM hypertension group and white coat hypertension （WCH） group, with 30 healthy male pilots as the control group. Results 17 cases （53.13%） were diagnosed with grade 1 hypertension by ABPM and 15 cases（46. 88% ） with white coat hypertension. Night systolic blood pressure fall rate （nSBPF） and night diastolic blood pressure fall rate （nDBPF） were similar in these three groups. There was statistically significant difference between the three groups in 24 h systolic blood pressure load （24 h SBPL） and 24h diastolic blood pressure load （24 h DBPL）. Conclusion ABPM hypertension group and WCH group can maintain normal the circadian rhythm. 24 h SBPL and 24 h DBPL are much more sensitive indexes for classifying the three groups. ABPM can be used as an important reference index of early diagnosis ,treatment and medical evaluation of aircrews with hypertension.