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|本期目录/Table of Contents|

非杓型血压的临床特点及相关因素分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第2期
页码:
154-156
栏目:
临床研究
出版日期:
2014-01-20

文章信息/Info

Title:
Clinical characteristics and relative factors of nondipping hypertension
作者:
陈 震; 蒋益波; 孙 欣; 徐曙东; 蒋智慧
(泰兴市人民医院心内科，江苏 泰兴 225400)
Author(s):
CHEN Zhen;  JIANG Yi-bo;  SUN Xin;  XU Shu-dong;  JIANG Zhi-hui
(Department of Cardiology, Taixing People’s Hospital, Taixing 225400, Jiangsu, China)
关键词:
高血压; 原发性; 杓型; 非杓型; 临床特点; 相关因素
Keywords:
hypertension;  dipper;  nondipping;  clinical characteristics;  relative factors
分类号:
R544.1
DOI:
-
文献标识码:
A
摘要:
目的:研究非杓型血压的临床特点和相关因素，以提高非杓型血压的知晓率和治疗率。方法： 选择原发性高血压或其他心脏疾病并发原发性高血压，并排除严重并发疾病的患者。收集临床资料，并行血生化、心电图、心超等辅助检查。所有患者进行24小时动态血压监测，将夜间平均血压与白天比较，无下降者，为反杓型血压组，下降超过10%，为杓型血压组，下降不超过10%，为非杓型血压组，并分析其临床特点。结果： 共55例入选，所有患者均为高血压Ⅱ级或Ⅲ级，杓型血压者19例（35%），非杓型者22例（40%），反杓型者14例（25%），广义非杓型血压共36例（占65%）。不同血压节律组间比较，年龄、冠心病史、脑卒中史、血浆尿素氮及夜间收缩压、舒张压差异有显著性。Logistic回归提示冠心病史、脑卒中史、血浆尿素氮增高为血压昼夜节律异常的影响因素。结论： 住院高血压病患者中非杓型血压的发生率较高，冠心病、脑卒中、血浆尿素氮增高的患者是非杓型血压的相关因素。
Abstract:
AIM:To study the clinical manifestations and relative factors of nondipping hypertension in order to improve its diagnosis and treatment. METHODS: Patients with primary hypertensive or other cardiovascular diseases without severe complications were selected. After collecting clinical data including laboratory blood sample analysis, electrocardiograph (ECG) and echocardiogram examination, all patients underwent a 24-h ambulatory blood pressure monitoring (ABPM) procedure. Nocturnal blood pressures (BP) were compared with diurnal BPs. Dipping hypertension was defined if the mean nocturnal reduction of BP was 10% or above, whereas nondipping BP was defined if the reduction was <10%. The anti-dipper BP was defined if there was no drop in nocturnal BP. Clinical manifestations of these types were compared. RESULTS: Among the 55 selected patients diagnosed with class 2 or 3 hypertension, dipping hypertension, nondipping hypertension and anti-dipping hypertension were detected in 19 (35%), 22 (40%) and 14 (25%) cases, respectively. Statistical significance was found among the three groups in aspects such as age, historical episode of coronary disease or stroke, blood serum urea nitrogen (BUN) level, and mean nocturnal systolic/diastolic blood pressure (SBPn/DBPn). Logistic regression analysis indicated that history of coronary diseases or stroke and high BUN level were contributing factors to the abnormal circadian rhythms of BP. CONCLUSION: Morbidity of nondipping hypertension is relatively high in hospitalized patients. Coronary disease, stroke and high level BUN are defined as its relative factors.

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备注/Memo

备注/Memo:
收稿日期：2013-09-07.
作者简介：陈震，副主任医师，博士Email：cardiologist_cn@163.com
更新日期/Last Update: 2014-01-16