社区原发性高血压病患者的血压变异性特征研究

目的　了解社区原发性高血压病患者的血压变异性（BPV）特征。方法　选取2016年12月—2017年6月在青岛市市北区延安路街道社区卫生服务中心门诊就诊的原发性高血压病患者130例。患者每个月至门诊随访1次，均随访超过3次。以收缩压变异系数（CV）表示BPV，计算患者随访期间的CV，并对不同平均收缩压、合并症、服药情况及是否有并发症患者进行比较。结果　是否有并发症及不同合并症患者的CV比较，差异无统计学意义（P>0.05）；不同平均收缩压、服药情况患者的CV比较，差异有统计学意义（P<0.05）。其中，平均收缩压为<160 mm Hg患者的CV低于平均收缩压≥160 mm Hg的患者，规律服药患者的CV低于未规律服药的患者，差异有统计学意义（P<0.05）。结论　平均收缩压和服药情况对长时BPV有影响，提示社区卫生工作者不仅应关注高血压患者的血压平均值，也应关注其BPV情况。

Blood Pressure Variability in Patients with Essential Hypertension from the Community

Objective　To analyze blood pressure variability（BPV） in patients with essential hypertension from the local community health service center.Methods　A total of 130 patients with essential hypertension who had visited the local community health service center（Yan'an Rd，Shibei District，Qingdao） were selected as study samples from December 2016 to June 2017.Each patient was followed up in the community health service center once a month with more than three times of follow-up in total.Systolic blood pressure coefficient of variation（CV） was selected to represent BPV and was calculated during follow-up.Comparison was conducted among patients with different mean systolic blood pressure，comorbidities，medication intake and between patients with and without complications.Results　There was no statistical significance in systolic blood pressure CV among patients with different comorbidities and between patients with and without complications（P>0.05）．Statistical significance could be found in systolic blood pressure CV when comparing patients with different mean systolic blood pressure and medication intake（P<0.05）．Lower systolic blood pressure CV could be found in patients with mean systolic pressure<160 mm Hg comparing with those with mean systolic blood pressure≥160 mm Hg（P<0.05）．Patients who took medicine regularly showed lower systolic blood pressure CV than those who did not take medicine regularly（P<0.05）．Conclusion　Mean systolic blood pressure and medication intake have an impact towards long term BPV.Medical workers in community health service centers shall not only pay attention to the mean blood pressure of patients with essential hypertension，but also pay attention to their BPV.