原发性高血压患者血压昼夜节律的影响因素分析.docVIP

原发性高血压患者血压昼夜节律的影响因素分析 张　娟１，任　辉２，钟　理１（400038重庆，第三军医大学：西南医院心内科1，护理学院2） [摘要]　目的　探讨原发性高血压患者非杓型血压昼夜节律形成的危险因素。方法 将患者按夜间平均动脉压下降率分为杓型组(49例)与非杓型组(83例)，对患者行横断面调查，采用Logistic回归分析筛选影响因素。结果 非杓型组夜间收缩压、舒张压、血压负荷及24 h收缩压、收缩压负荷均高于杓型组（P0.05）；非杓组年龄60岁、合并靶器官损害、超重和肥胖、睡眠质量差的患者比例均高于杓型组（P0.05）；Logistic回归也显示年龄增长（OR=1.071, 95%CI 1.027~1.117）、靶器官损害（OR=5.457, 95%CI 2.134~13.959）、体质指数24 kg/m2（OR=4.341, 95%CI 1.652~11.411）、睡眠质量差　（OR=0.948, 95%CI 1.039~6.403）为原发性高血压患者血压昼夜节律异常的危险因素。结论 应加强对老年人、有靶器官损害、超重和肥胖、睡眠质量差的原发性高血压患者的药物疗效监测和生活方式干预，以预防及早期预测异常血压昼夜节律的发生。　 [关键词]　原发性高血压；动态血压；昼夜节律；生活方式 Influencing factors on circadian rhythm of blood pressure in essential hypertension patients Zhang Juan, Ren Hui, Zhong Li (Cardiovascular section of The First Hospital Affiliated to The Third Military Medical University, Chongqing, China 400038; Nursing Institute of The Third Military Medical University, Chongqing, China 400038) [Abstract] Objective To explore risky factors on non-dipper circadian rhythm of blood pressure in essential hypertension patients. Methods Dividing the patients into two groups—dippers(49 cases) and non-dippers(83 cases) according to the nocturnal reduction rate of mean arterial pressure (MAP). All the patients receive a cross-sectional survey. Risk factors are screened out by Logistic regression analysis. Results Nocturnal systolic BP, diastolic BP, mean arterial pressure, BP load and 24-hour systolic BP, systolic BP load in non-dippers are higher than those in dippers（P0.05）. Patients older than 60, with target organ damage(TOD), being overweight and obese, having good sleep quality take up greater percentage in non-dippers than those in dippers（p0.05）. Binary logistic regression analysis shows increased age（OR=1.071, 95%CI 1.027-1.117）, TOD（OR=5.457, 95%CI 2.134-13.959）, body mass index(BMI)≥24kg/m2（OR=4.341, 95%CI 1.652-11.411）), bad sleep quality（OR=0.948, 95%CI 1.039-6.403） are major risk factors of abnormal circadian rhythm of blood pressure. Conclusions It is necessary to s