高血压病患者血压变异性与靶器官损害的相关性研究

目的为评价高血压病患者血压变异性与靶器官损害程度的关系。方法对１５例正常人及４３例高血压病患者按临床分期进行了２４小时无创性动态血压监测。结果高血压病Ⅲ期组２４小时、日间及夜间的收缩压、舒张压的血压变异系数（ＣＶ）均显著大于Ⅱ期组和Ｉ期组（Ｐ＜０．０５），Ⅱ期组的２４小时、日间的收缩压、舒张压和夜间的舒张压的血压变异系数亦显著大于１期组（Ｐ＜０．０５）；血压变异度（ＳＤ）Ⅲ期组２４小时、日间及夜间的收缩压、舒张压和Ⅱ期组２４小时收缩压、日间收缩压明显高于Ｉ期组（Ｐ＜０．０５）。高血压病Ⅲ期、Ⅱ期组的血压变异系数明显大于对照组（Ｐ＜０．０５）；血压变异度Ⅲ期组以及Ⅱ期组的２４小时收缩压、日间收缩压和夜间收缩压、舒张压显著大于对照组（Ｐ＜０．０５），高血压病Ｉ期组的血压变异系数及血压变异度与对照组相比，无显著差异。结论随着靶器官损害加重，血压变异性亦增大，血压变异系数不受降压药物治疗的影响，应用动态血压监测高血压病患者的血压变异系数对评价靶器官的损害程度有一定价值。

The relationship of blood pressure variability and the damage of target organ in hypertensive patients

in order to assess the relationship of blood pressure variability and the damage of targetorgan in hypertensive patients,we observed 43 hypertensive patients in different clinical stage with 24hour noninvasive ambulatory blood pressure monitoring (ABPM). All of them were in antihypertensivetreatment. The results showed that the coefficient of blood pressure variation of 24-hour, daytime andnighttime systolic blood pressure (SBP),diastolic blood pressure (DBP) in stage-III-group were significantly higher than that of stage-I-group and stage-II-group (P<0. 05). The coefficient of blood pressurevariation of 24h,daytime SBP,DBPand nighttime DBP in stage-II-group were also greater than that ofstage-I-group (P<0. 05). While only the degree of blood pressure variation of 24h, daytime,nighttimeSBP, DBP in stage-ill-group and 24h SBP, daytime SBP in stage-II-group were greater than that ofstage-I-group (P<0. 05). As the target-organ damage was aggravated, the blood pressure variabilitywas increased. The degree of blood pressure variation was affected by antihypertensive drugs,but the coefficient of blood pressure variation after treatment was the same as before. Therefore,to some extent,detecting the coefficient of blood pressure variation of hypertensive patients by ABPM is valuable in estimating the degree of target organ damage.