高原高血压患者的血压变异性分析

ANALYSIS OF BLOOD PRESUER VARAIBILITY TO HIGH-ALTITUDE HYPERTENSION PATIENTS

目的 探讨世居和移居高原的高血压患者血压变异性(BPV)特点及其意义。 方法 对176例世居和移居高原的高血压病患者在平原地区(成都)进行24小时动态血压监测(ABPM)并对其结果进行统计,将24小时血压负荷值≥25％者作为观察组,<25％者作为对照组,以测得的血压标准差作为BPV指标。结果 两组民族间BPV各指标的比较相近(P均>0.05);24小时最高、最低、平均血压和24小时、白昼、夜间血压,观察组均显著高于对照组(P均<0.01),24小时平均心率两组相近(P>0.05);24小时BPV各指标观察组均显著大于对照组(P均<0.01)。观察组左室肥厚的检出率显著高于对照组(P<0.01),各种并发症的检出率相近(P>0.05)。 结论 世居和移居高原的高血压病患者BPV受多种因素的影响,缺氧是影响BPV和血压的主要因素。这种对血压调节系统的刺激作用对世居和移居患者是同等的。BPV和血压的变化白昼大于夜间,收缩压大于舒张压且血压负荷值越大,BPV越大,左室重构的机会越多。

Purpose To study the characteristics and significances of blood pressure variability (BPV) on high-altitude hypertension patients by comparison with native Tibetan and Han migrants. Methods 176 hypertension patients among native Tibetan and Han migrants have been studied by testing and evaluating their 24 hour Ambulatory blood pressure monitoring(ABPM) results. And taking the tested standard deviation of blood pressure as BPV's index in this study, according to their load value of blood pressure (LVBP) , dividng them into 2 groups with observe group which LVBP was more than 25% and control group which LVBP was Less than 25% .Results By comparison ,the BPV's indexes are similar among these 2 nationalities (P > 0.05) .While in observe group, the highest, lowest and day time, night time of 24 hour blood pressure are obviously higher than control group(P < 0.01) .The 24 hour heart rate of in 2 groups are similar (P > 0 .05) . The detected rate of left ventricular hypertrophy in observe group is higher than control group, and other complications in 2 groups are no differences (P > 0.05) . Conclusion The BPV of hypertension patients in native Tibetan & Han migrants are affected by various factors, and hypoxia would be the main factor on influencing BPV and BP. Changes of BPV and BP are more obvious in day time than nigh time, and the systolic pressure shows higher than diastolic pressure. Moreover,the higher LVBP is,the bigger BPV and more chances of Left ventrcular hypertrophy would occur.