妊娠高血压综合征孕妇24-h的血压变异性

Blood pressure variability of initially diagnosed pregnancy-induced hypertension syndrome

目的观察初期诊断妊娠高血压综合征(PIHS)患者24-h动态血压变化特点。方法应用动态血压监测仪观察63例初期诊断PIHS患者(PIHS组)和健康孕妇对照(C组)的24-h动态血压,分析昼夜变化特征。PIHS组随访结束时,评定为轻度PIHS者20例(A1组)、中度PIHS者25例(A2组)和重度PIHS者18例(A3组),分层分析血压变异性与其病情的关系。结果 A1、A2和A3组24-h、白天和夜间的收缩压(SBP)、舒张压(DBP)和脉压均高于C组(P<0.05),但A2、A3两组无统计学差异(P>0.05)。PIHS组24-h、白天和夜间的SBP和DBP变异性均较C组高(P<0.05),且随严重程度的增加而增加(P<0.05)。PIHS组24-h、白天及夜间血压负荷均高于C组(P<0.05),且随严重程度的增加而增加(P<0.05)。PIHS组SBP和DBP夜间下降值和下降率均小于C组(P<0.05)。结论 PIHS患者血压变异性与其病情相关。

Objective To investigate the characteristics of 24-hour ambulatory blood pressure in the pregnant women with initial diagnosis of pregnancy-induced hypertension syndrome（PIHS）. Methods The 24-hour ambulatory blood pressures were monitored with Spacelabs 90219 BP monitor in 63 pregnant women with initial diagnosis of PIHS（group PIllS） and 20 healthy pregnant women （group C）. The patients in group PIHS were followed up. At the end of follow up, the patients in group PIHS were assigned into three subgroups of A1 （with slight PIHS, 20 cases）, A2 （with moderate PIHS, 25 cases） and A3（with severe PIHS, 18 cases）. The stratification analysis of 24-hour blood pressure variability was performed. Results The systolic blood pressures（SBP）,diastolic blood pressures（DBP） and pulse pressures in 24 hours, day time and night were all significantly higher in groups of A1, A2 and A3 than those in group C （P〈0. 05）, which were not significantly different between groups of A2 and A3（P〉0. 05）. The variability of SBP and DBP in 24 hours, day time and night was higher that in group C（P〈0. 05）, which was remarkable as PIHS illness became severe, so did the blood pressure load（P〈0. 05）. The decsease and decline rate of SBP and DBP at night were less in group PIHS than those in group C（P〈0. 05）. Conclusion The blood pressure variability is significantly associated with illness condition of pregnant women with initial diagnosis of PIHS.