【摘要】 目的探讨区分不同节律类型原发性高血压方法 ,以指导临床合理选择降压药和给药时间。方法 95例原发性高血压患者,采用24 h动态血压监护仪对所有患者进行24 h动态血压监测(ABPM)分析。分析患者的节律构成[杓型(DH)、超杓型(UDH)、非杓型(NDH)、反杓型(ADH)],并观察比较不同节律类型患者的24 h收缩压平均值(24 h MSBP)、24 h舒张压平均值(24 h MDBP)、白昼收缩压平均值(dMSBP)、白昼舒张压平均值(dMDBP)、夜间收缩压平均值(nMSBP)、夜间舒张压平均值(nMDBP)、收缩压夜间下降率(SBPF)、舒张压夜间下降率(DBPF)。结果 95例患者中,正常节律(杓型节律)患者19例,占20%;异常节律患者76例,占80%,其中超杓型19例、非杓型30例、反杓型27例。不同节律类型患者的dMDBP、nMSBP、nMDBP、SBPF、DBPF比较差异具有统计学意义(P<0.05)。进一步采用SNK法两两比较,任意两种节律类型患者的nMSBP、nMDBP、SBPF、DBPF比较差异均具有统计学意义(P<0.05)。结论 nMSBP、nMDBP、SBPF及DBPF均能较好地区分不同节律类型高血压。更多还原

【Abstract】 Objective To investigate the method of distinguishing different types of rhythms in patients with essential hypertension, so as to guide rational selection of antihypertensive drugs and administration time. Methods A total of 95 patients with essential hypertension were analyzed with 24 h ambulatory blood pressure monitoring(ABPM) by 24 h ambulatory blood pressure monitor. Rhythm constitution [dipper hypertension(DH) and ultra dipper hypertension(UDH), non dipper hypertension(NDH), anti dipper hypertension(ADH)] was analyzed, and observation and comparison were made on patients with different types of rhythm of 24 h mean systolic blood pressure(24 h MSBP), 24 h mean diastolic blood pressure(24 h MDBP), daytime mean systolic blood pressure(dMSBP), daytime mean diastolic blood pressure(dMDBP), nocturnal mean systolic pressure(n MSBP), nocturnal mean diastolic blood pressure(nMDBP), systolic blood pressure fall rate(SBPF), diastolic blood pressure fall rate(DBPF) at night. Results Among 95 patients, 19 patients were normal rhythm(dipper rhythm), accounting for 20%; 76 patients were abnormal rhythm, accounting for 80%, including 19 cases of super dipper type, 30 cases of non dipper type, and 27 cases of anti dipper type. Patients with different types of rhythms had statistically significant difference in dMDBP, nMSBP, nMDBP, SBPF and DBPF(P<0.05). Further SNK analysis showed that there was statistically significant difference in nMSBP, nMDBP, SBPF and DBPF between two types of rhythms(P<0.05). Conclusion nMSBP, nMDBP, SBPF and DBPF can better distinguish between different rhythm types of hypertension.更多还原