老年人动态高血压水平监测的临床价值分析

Influence of Blood Pressure Variability on Target Organ Damage and Accompanying Clinical Condition

目的 :探讨老年高血压病 (EH)患者动态血压监测 (ABPM)的临床应用价值及血压水平对靶器官和临床情况的影响。方法 :采用美国AccutrakerDx型无创性全自动血压监测仪 ,对 139例老年EH患者和 83例老年健康者进行 2 4hABPM ,将监测值和临床资料进行综合分析及统计学处理。结果 :1 老年EH患者平均动脉血压参数明显高于对照组 ;各级高血压平均动脉血压参数均明显高于对照组 ;各级高血压之间平均动脉收缩压比较 ,有显著性差异。 2 随血压水平升高 ,靶器官损害 (TOD)及伴随临床情况 (ACC)发生率升高 ,但前者升高有显著性差异 ,后者无显著性差异。结论 :在ABPM各参数中 ,平均动脉血压是一个重要参数 ,对老年人来说 ,平均动脉收缩压更为重要。血压水平与TOD和ACC相关 ,血压水平越高 。

Objective: To evaluate the clinical value of ambulatory blood pressure monitoring (ABPM), and to find out the relationship of the blood pressure mean and variability to the severity of target organ damage and to the alteration of clinical manifestation in aged patients with essential hypertension(EH).Methods: Noninvasive bloo d pressure recorder (Accutraker Dx) was used to conduct 24 hour ABPM in 139 aged patients with EH and 83 aged controls. The Statistical analysis was done to the obtained monitoring values and clinical data.Results: The index of mean arterial blood pressure in aged pa tients with EH was higher than that in aged controls. The index of mean arterial blood pressur e in each rank of aged patients with EH was totally higher than that in aged con trols. Among the ranks, the mean systolic blood pressure was different significa ntly. The incidence of target organ damage or accompany clinical condition(ACC) was increased with increasing of the level of blood pressure, but the significan t difference appeared only in the incidence of TOD, not in ACC. Conclusio n: In a ll indexes of ABPM, the index of mean arterial blood pressure was an important i ndex. The mean systolic blood pressure was important especially in aged patients . The incidence of TOD or ACC was closely related with the level of blood pressu re. The higher the level of blood pressure presents, the higher the incidence of TOD or ACC appears.