原发性高血压患者脉压与血压昼夜节律分析

Analysis between pulse pressure and diurnal rhythm of blood pressure in patients with essential hypertension

目的:探讨脉压在高血压患者中各年龄组间分布及与血压昼夜节律的关系。方法:选用我院住院确诊为原发性高血压病男性患者 2 6 3例 ,将患者分为≤ 39岁、4 0～ 4 9岁、5 0～ 5 9岁、6 0～ 6 9岁和≥ 70岁组 ;并根据1999年 WHO/ ISH及我国高血压指南最新诊断分层标准将患者分为低危组、中危组、高危和极高危组 ;监测 2 4小时血压昼夜节律 ,分析脉压在不同年龄组的分布及与血压昼夜节律和高血压各分层组间的关系。 结果 :(1)≤ 39岁组与 4 0～ 4 9岁、5 0～ 5 9岁、6 0～ 6 9岁组比较脉压无显著性差异 ;≥ 70岁组脉压高于其他年龄组 ,随着年龄的增大 ,脉压逐渐增大。 (2 )同组间日间与夜间脉压相比无显著性差异。 (3)杓型与非杓型血压组脉压相比无显著性差异。 (4)非杓型血压随着年龄的增加所占血压形态比例逐渐增加。 (5 )高危和极高危高血压者脉压均高于低危和中危组高血压者脉压。 结论 :脉压增大是反映动脉顺应性减低及动脉硬化的一个标志 ,其与血压昼夜节律是两种不同的表现形式 。

Objective: To investigate distribution feature on pulse pressure among different ages, and relation to diurnal rhythm of blood pressure in essential hypertension. Methods: 263 inpatients with essential hypertension were analysed; according to ambulatory blood pressure, their pulse pressure distribution and diurnal rhythm of blood pressure were studied in ≤30, 40～49, 50～59, 60～69 and ≥70 age groups respectively and they were divided into dipper group and non dipper group: low, medium, high and very high risk groups. The 24 hour ambulatory blood pressure records were obtained with ambulatory blood pressure equipment. Results: (1) pulse pressure showed no significant difference between ≤30 and 40～49, 50～59, 60～69 age groups, and pulse pressure in ≥70 age group was higher than ≤30, 40～49, 50～59 age group. (P<0.05). The pulse pressure was becoming wider with age increasing. (2) The pulse pressure was not significant between day pulse pressure and night pulse pressure, dipper and non dipper groups. (3) The pulse pressure in high risk and very high risk groups was higher than low and medium risk groups. Conclusion: The wide pulse pressure is a marker of reduced artery distensibility, increased artery stiffness and atherosclerosis. It is associated with age, duration of essential hypertension and severer degree of blood pressure. The pulse pressure and diurnal rhythm of blood pressure are two different types. Both of them have clinical value for evaluation of prognosis and target organ damage of essential hypertension.