动态血压监测在评价高血压靶器官损害中的预测价值

目的探讨动态血压监测(ABPM)在评价高血压靶器官损害中的预测价值。方法对120例原发性高血压(EH)患者(女42例，男78例)的24hABPM和偶测血压(CBP)与EH所致靶器官损害(心房颤动、室性心律失常、充血性心力衰竭、脑血管意外)的相关性进行比较。结果24h动态平均SBP和上述各项事件有明显的相关性，相关系数分别为0．3001，0．3114，0．3921，0．4222，P<0．01；24h动态平均DBP亦和上述各项事件有相关性，相关系数依次为0．2998，0．3095、0．2430，0．3005，P<0．01；CBP与EH所致靶器官损害无相关性。脑血管意外的发生与夜间平均SBP和DBP有更明显的相关性，相关系数分别为0．6005，0．4568，P<0．001。研究还发现动态血压中有"杓"型变化者比无"杓"型变化者的EH心脑血管并发症发病率明显降低。血压负荷>25％是心脑血管病发生的危险信号之一。结论了解EH患者的24h血压变化对预测EH并发症的发生和指导合理治疗有重要意义。注重夜间血压的降低是减少脑血管病发生的一有效措施。

The value of ABPM in predicting target organ damage caused by hypertension

Objective: To study the value of ABPM in predicting target organ damage caused by hypertension. Method:We studied the relationship between 24 h ambulatory blood pressure monitoring (24 h ABPM), casual blood pressure (CBP) and target organ damage (atrial fibrillation, ventricular arrhythemia, congestive heart failure,cerebral vascular accident) caused by hypertension in 120 cases of hypertension (42 femals, 78 males). Result: 24 h ambulatory mean BP had clear relevance to the events mentioned above. The relevant factors were 0. 300 1,0. 311 4,0. 392 1,0. 422 2 respectively (P ＜0.01). 24 h mean.dBP was also relevant to them, the relevance factors were 0. 299 8, 0. 309 5,0. 243 0,0. 300 5 respectively (P ＜ 0.01 ), CBP was not relevant to the target organ damage caused by hypertension. Tbe occurrence of cerelbal vascular diseases was clearly relevant to nocturnal mean SBP and dBP,the relevant factors were 0. 600 5,0. 456 8 respectively ( P ＜0. 001). In the study, we found that the occurence rate of cardiocerebral vascular complications was much lower among HT patients who had a ABPM with a "dipper" type than patients who did not. BP load＞25% was one signal for occurrence of cardiocerebral vascular diseases. Conclusion: ABPM may help us to predict the incidence of complications related to HT and provide optimal treatment. Lowering noctunal BP is an effective way of reducing the incidence of cerehrovascular complication