不同亚型高血压与靶器官损伤的相关性研究

The correlation between different sub-types of hypertension and target organ damage

目的探讨不同亚型高血压与靶器官损伤的相关性。方法随机选取该院2016年12月至2017年3月行动态血压监测且完善心脏、颈部血管超声及冠状动脉计算机断层造影(CTA)、头颅电子计算机断层扫描(CT)或磁共振(MRI)检查的研究对象310例。根据检测结果分为4组,正常血压组46例,单纯日间高血压组60例,单纯夜间高血压组91例,全天持续型高血压组113例。比较各组临床特征并观察靶器官损伤的差异性。结果单纯夜间高血压组和全天持续型高血压组至少3个靶器官损伤的比例明显高于正常血压组(P<0.05),与单纯日间高血压组比较,差异也有统计学意义(P<0.05)。结论单纯日间高血压组、单纯夜间高血压组、全天持续型高血压组均对靶器官有损伤,而单纯夜间高血压和全天持续型高血压是靶器官损伤的明显危险因素,其中单纯夜间高血压导致全身多处靶器官损伤的风险更大。临床应重视夜间高血压的诊断及管理,积极采用24h动态血压进行监测和评估。

Objective To investigate the correlation between different sub-types of hypertension and target organ damage. Methods In this study,310 cases of patients were selected randomly in our hospital,which after completing ambulatory blood pressure monitoring （ABPM） and improved cardiac,cervical vascular ultrasound and coronary CTA,cranial CT or MRI from December 2016 to March 2017.Then their clinical data and laboratory data were collected and divided them into 4 groups according to their results of ABPM.Among them,there were 46 cases of normal blood pressure group,60 cases of simple daytime hypertension group,91 cases of simple nighttime hypertension group and 113 cases of sustained hypertension group.The clinical characteristics of each group were compared and the difference of target organ injury was observed. Results The proportion of nighttime hypertension and sustained hypertension in at least three target organs was significantly higher than that in normal blood pressure group （ P 〈0.05）,which was also different from that in daytime hypertension alone （ P 〈0.05）. Conclusion In this cross-sectional study,both the duration of daytime and nighttime persistent hypertension have impaired target organs,whereas nighttime hypertension and sustained hypertension are a significant risk factor for target organ damage.Among them,the simple nighttime hypertension leads to a greater risk of multiple target organ damage in the whole body.In clinical work,we need to pay more attention to the diagnosis and management of nighttime hypertension and actively use the ABPM to monitor and estimate the blood pressure.