陈 震, 蒋益波, 孙 欣, 徐曙东, 蒋智慧. 非杓型血压的临床特点及相关因素分析[J]. 心脏杂志, 2014, 26(2): 154-156.
    引用本文: 陈 震, 蒋益波, 孙 欣, 徐曙东, 蒋智慧. 非杓型血压的临床特点及相关因素分析[J]. 心脏杂志, 2014, 26(2): 154-156.
    Clinical characteristics and relative factors of nondipping hypertension[J]. Chinese Heart Journal, 2014, 26(2): 154-156.
    Citation: Clinical characteristics and relative factors of nondipping hypertension[J]. Chinese Heart Journal, 2014, 26(2): 154-156.

    非杓型血压的临床特点及相关因素分析

    Clinical characteristics and relative factors of nondipping hypertension

    • 摘要: 目的:研究非杓型血压的临床特点和相关因素,以提高非杓型血压的知晓率和治疗率。方法: 选择原发性高血压或其他心脏疾病并发原发性高血压,并排除严重并发疾病的患者。收集临床资料,并行血生化、心电图、心超等辅助检查。所有患者进行24小时动态血压监测,将夜间平均血压与白天比较,无下降者,为反杓型血压组,下降超过10%,为杓型血压组,下降不超过10%,为非杓型血压组,并分析其临床特点。结果: 共55例入选,所有患者均为高血压Ⅱ级或Ⅲ级,杓型血压者19例(35%),非杓型者22例(40%),反杓型者14例(25%),广义非杓型血压共36例(占65%)。不同血压节律组间比较,年龄、冠心病史、脑卒中史、血浆尿素氮及夜间收缩压、舒张压差异有显著性。Logistic回归提示冠心病史、脑卒中史、血浆尿素氮增高为血压昼夜节律异常的影响因素。结论: 住院高血压病患者中非杓型血压的发生率较高,冠心病、脑卒中、血浆尿素氮增高的患者是非杓型血压的相关因素。

       

      Abstract: AIM:To study the clinical manifestations and relative factors of nondipping hypertension in order to improve its diagnosis and treatment. METHODS: Patients with primary hypertensive or other cardiovascular diseases without severe complications were selected. After collecting clinical data including laboratory blood sample analysis, electrocardiograph (ECG) and echocardiogram examination, all patients underwent a 24-h ambulatory blood pressure monitoring (ABPM) procedure. Nocturnal blood pressures (BP) were compared with diurnal BPs. Dipping hypertension was defined if the mean nocturnal reduction of BP was 10% or above, whereas nondipping BP was defined if the reduction was <10%. The anti-dipper BP was defined if there was no drop in nocturnal BP. Clinical manifestations of these types were compared. RESULTS: Among the 55 selected patients diagnosed with class 2 or 3 hypertension, dipping hypertension, nondipping hypertension and anti-dipping hypertension were detected in 19 (35%), 22 (40%) and 14 (25%) cases, respectively. Statistical significance was found among the three groups in aspects such as age, historical episode of coronary disease or stroke, blood serum urea nitrogen (BUN) level, and mean nocturnal systolic/diastolic blood pressure (SBPn/DBPn). Logistic regression analysis indicated that history of coronary diseases or stroke and high BUN level were contributing factors to the abnormal circadian rhythms of BP. CONCLUSION: Morbidity of nondipping hypertension is relatively high in hospitalized patients. Coronary disease, stroke and high level BUN are defined as its relative factors.

       

    /

    返回文章
    返回