动态血压监测临床价值研究

目的：研究动态血压监测在高血压诊断、判断左室肥厚及指导临床用药中的作用。方法：应用动态血压监测和超声心动图检查６２例正常血压，６４例原发性高血压及４例继发性高血压。结果：动态血压均值小于偶测血压均值（Ｐ＜０．０１），白大衣性高血压占１０％。动态血压负荷可区分不同时期高血压（Ｐ＜０．０５），血压正常组、高血压Ⅰ期组存在昼高夜低昼夜节律。高血压Ⅱ、Ⅲ期及继发性高血压昼夜节律消失。非杓型高血压与左室重量及重量指数相关性较杓型高血压为好（Ｐ＜０．０５），硝苯啶时程投药疗效更好（Ｐ＜０．０５）。硝苯啶缓释片不受投药时程限制（Ｐ＞０．０５）。结论：动态血压监测在临床上对高血压诊断、分期、判断左室肥厚及指导用药有重要价值

THE STUDY OF AMBULATORY BLOOD PRESSURE MONITORING IN CLINICAL USE

Objective: To study the effects of 24-hour ambulatory blood pressure monitoring (ABPM) in diagnosis of hypertension, evaluation of degree of left ventricular hypertrophy and guide to drug therapy. Methods: 62 normal subjects, 64 essential and 4 secondary hypertensives were tested respectively by 24h ABPM and echocardiography. Results: The mean BP tested by 24h ABPM was lower than that by occasional BP ( P <0.01). White-coat hypertension account for 10%. Different stage of hypertension can be recognized by ambulatory BP load ( P <0.05). There was definite variation, i.e. diurnal BP is higher than nocturnal BP in normal subjects and hypertensive in stage . While that variation disappeared in hypertensive in stage and . there was more relevant to left ventricular mass for non-dipper hypertensives than dipper hypertensives ( P <0.05). Nifedipine taken in regular time was better than routine treatment ( P <0.05). The effects of slow-released nifedipine was not affected by the time of taking drugs( P >0. 05). Conclusion: 24h ABPM is an indispensable way for understanding clinical hypertension stage, left ventricular hypertrophy and guiding drug therapy.