岁以上老高血压患者动态脉压及昼夜血压节律与靶器官损害关系.docVIP

70岁以上老年高血压患者动态脉压及昼夜血压节律与靶器官损害的关系 【摘要】 目的 探讨老年原发性高血压患者24小时平均收缩压、舒张压、动态脉压、昼夜血压节律与靶器官损害的关系。方法 (1)对684例观察对象进行24小时动态血压监测，其中血压正常组312例，单纯血压升高的原发性高血压患者为原发性高血压组145例，原发性高血压伴靶器官损害组227例，对比分析24小时动态脉压监测各指标。(2)根据动态血压监测的高血压患者的昼夜节律，依据夜间血压下降率将其分为两组，夜间下降率小于10%为非杓型组，大于或等于10%为杓型组。结果 (1)伴靶器官损害组白昼舒张压、夜间舒张压低于原发性高血压组(Plt;0.01);(2)随高血压患者病变程度的加重，脉压也随之增大(Plt;0.01)，依次为伴靶器官损害组、原发性高血压组和血压正常组;(3)靶器官损害组大多为非杓型血压节律，与原发性高血压组比较差异显著(Plt;0.01)。结论 (1)动态脉压的变化可以反映高血压患者病变程度，舒张压低及动态脉压增大是原发性高血压伴靶器官损害患者动态脉压变化特点之一。(2)非杓型血压节律的老年高血压患者较杓型血压节律者的靶器官损害更明显。 【关键词】 血压监测;高血压; 靶器官损害;脉压; 昼夜节律 　Abstract Objective To discuss the relationship of the average systolic pressure, diastolic pressure and circadian rhythm in 24 hours with the target organs damages in senile patients with primary hypertension.Methods 1. 24-hour dynamic monitoring of blood pressure was made to 684 cases, including 312 cases with normal blood pressure, 145 with primary hypertension and 227 cases with both primary hypertension and target organs damages, and a comparative analysis was made to the data of the monitoring; 2. According to night blood pressure fall rate, the cases were divided into 2 groups: non-dipper group (nigh blood pressure fall rate lt;10%) and dipper group (night blood pressure fall rate ≥10%).Result 1. The daytime and night diastolic blood pressures of the cases with both primary hypertension and target organs damages were lower than those of the cases with only primary hypertension (Plt;0.01); 2. With the aggravation of hypertension, the pulse pressure increased (Plt;0.01), the most were the cases with both primary hypertension and target organs damages, then the cases with primary hypertension and then the cases with normal blood pressure; 3. The cases with target organs damages were most often with non-dipper circadian rhythm, which was of obvious difference in the comparison with those with primary hypertension (P lt;0.01). Conclusions 1. The changes of ambulatory pulse pressure reflect the pathologic process of the cases with h