家庭血压测量诊断白大衣高血压患者的心血管风险作用研究

Study on the cardiovascular risk of home blood pressure measurement in the diagnosis of White coat hypertension

目的:探讨在白大衣高血压(WCH)患者心血管风险预测中,家庭血压测量的临床实践价值与临界值。方法:选取医院门诊治疗600例患者作为研究对象,分为三组即正常血压组、持续性高血压(HPB)组、WCH组,每组200例患者,对WCH患者进行持续3年的跟踪随访,进行心血管事件统计,记录各项血压监测结果,单因素和多因素分析WCH心血管风险高危因素,运用(ROC)曲线评价准确性,确定临界值。结果:经单因素分析发现,HBP组、WCH组诊室血压、办公室血压、家庭高血压监测结果6项差异均存在统计学意义(P<0.05);3年跟踪随访,WCH组患者84例合并心血管事件,心血管组入组15d、入组2年、入组3年的血压监测分析差异均存在统计学意义(P<0.05);多因素分析结果显示,家庭自测血压是WCH患者发生心血管的独立危险因素(P<0.05)。结论:家庭血压测量可作为WHC患者心血管风险事件的预测指标,便于实现对患者疾病的早期诊断治疗。

Objective:To explore the clinical value and critical value of home blood pressure measurement in cardiovascular risk prediction of White coat hypertension(WCH)patients.Method:600 outpatient patients treated in hospital were selected as the research subjects,divided into three groups:normal blood pressure group,high blood pressure HPB group,and WCH group.Each group had 200 patients,and WCH patients were followed up for 3 years.Cardiovascular event statistics were conducted,and various blood pressure monitoring results were recorded.Univariate and multivariate analysis of WCH cardiovascular risk high-risk factors was conducted,Use the receiver operating characteristic curve(ROC)to evaluate the accuracy and determine the critical value.Result:Through univariate analysis,it was found that there were statistically significant differences(P<0.05)between the HBP group and the WCH group in the monitoring results of six items:room blood pressure,office blood pressure,and home hypertension;After a 3-year follow-up,there were 84 patients in the WCH group with concurrent cardiovascular events.The blood pressure monitoring analysis of the cardiovascular group showed statistical differences(P<0.05)for 15 days,2 years,and 3 years of enrollment;The results of multivariate analysis showed that family self measured blood pressure was an independent risk factor for cardiovascular disease in WCH patients(P<0.05);Conclusion:Family blood pressure measurement can serve as a predictive indicator for cardiovascular risk events in WHC patients,in order to achieve early diagnosis and treatment of their diseases.