动态血压监测评价高血压病靶器官损害的进展

动态血压监测（ABPM）诸指标与高血压病病人心、脑、肾损害有较好的相关性，可作其预测因子和研究工具。大量研究证明：24h平均动态血压，日间血压无均值，夜间血压均值与心血管并发症的相关性较偶测血压为优；夜间血压降低减弱或消失的高血压病人与较高的心血管意外发生率相关；血压变异性与心血管损坏的严重性相关，而不依赖于血压水平；血压负荷是比血压水平更为精确的心血管危险预测指标；ABPM在预测高血压无症状脑血管损害方面较诊室随测血压为优；微量清蛋白尿是原发性高血压早期肾脏结构和功能改变的标志，尿清蛋白分泌率与24h收缩压和舒张压及24h日间，夜间平均血压显著相关。

Assessment of target-organ damage in hypertensive patients by ambulatory blood pressure monitoring

The indexes of ABPM(ambulatory blood pressure monitoring) have great correlation with the damage of heart,brain and kidney in hypertensive patients and may be used as predictive determinants and study tools.A lot of studies have shown the following facts:It is superior to clinical blood pressure in the relativity between the average 24h ambulatory blood pressure,average day blood pressure,average night blood pressure and cardiovascular complications;the less and disappearing of night-time blood pressure fall have correlated with the high rate of cardiovascular accident; the blood pressure variability is related with the severity of cardiovascular damage not depended on the level of blood pressure;the blood pressure load is an index of cardiovascular risk,which is more accurate than blood pressure level;in prognosticating non-symptomatic cerebrovascular damage,ABPM is better than clinical blood pressure;the micro-albumin urine is a sign of the changes of early nephritic structure and function in essential hypertension,urinary albumin excretion rate is related with 24h systolic pressure,24h diastolic pressure and the average 24h day and night blood pressure.