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目的探讨原发性高血压患者24h 收缩压、舒张压及脉压变化与靶器官损害的关系。方法对296例观察对象进行24h 动态血压监测,其中血压正常组92例,单纯血压升高的原发性高血压患者为原发性高血压组86例,原发性高血压伴靶器官损害患者为伴靶器官损害组118例。296例根据动态平均脉压水平分为3个亚组(脉压<40mmHg 组、40mmHg≤脉压<50mmHg组、脉压≥50mmHg 组),对比分析24h 动态血压监测各指标。将伴靶器官损害组按年龄分为<60岁、≥60岁2个亚组.观察对比24h 动态血压监测各指标的变化。结果 (1)伴靶器官损害组24h收缩压、白昼舒张压、夜间舒张压低于原发性高血压组(P<0.01);(2)随高血压患者病变程度的加重,脉压也随之增大(P<0.01),依次为伴靶器官损害组、原发性高血压组和血压正常组;(3)伴靶器官损害组两年龄间脉压差异无统汁学意义(P>0.05)。结论动态脉压的变化可以反映高血压患者病变程度,舒张压低及动态脉压增大是原发性高血压伴靶器官损害患者动态血压变化特点之一。
Objective To investigate the relationship between systolic blood pressure, diastolic blood pressure and pulse pressure and target organ damage in patients with essential hypertension. Methods A total of 296 subjects undergoing ambulatory blood pressure monitoring were enrolled in this study. Among them, 92 patients with normotensive subjects, 86 patients with essential hypertension with hypertension alone, and 86 patients with essential hypertension with target organ damage 118 cases with target organ damage group. 296 cases were divided into three subgroups (pulse pressure <40 mmHg group, 40 mmHg≤ pulse pressure <50 mmHg group, pulse pressure≥50 mmHg group) according to the dynamic mean pulse pressure level, and 24-hour ambulatory blood pressure monitoring indicators were compared. The target organ damage group was divided into two groups according to age, <60 years old, ≥60 years old.Observation 24h dynamic blood pressure monitoring indicators changes. Results (1) 24h systolic blood pressure, daytime diastolic pressure and nighttime diastolic pressure were lower in patients with target organ damage than those in essential hypertension group (P <0.01). (2) With the severity of hypertension, the pulse pressure also followed (P <0.01), followed by target organ damage group, essential hypertension group and normal blood pressure group; (3) there was no significant difference in pulse pressure between two groups with target organ damage (P> 0.05 ). Conclusion The change of dynamic pulse pressure can reflect the degree of diseased patients, diastolic depression and dynamic pulse pressure increase is one of the characteristics of ambulatory blood pressure changes in patients with essential hypertension and target organ damage.