24h动态血压监测在老年高血压患者中的应用

摘要

目的:探讨24h动态血压监测(ABPM)在老年高血压患者中的应用. 方法:选择2013年2月～2015年2月我院收治的老年高血压患者223例, 按照年龄患者被分为低龄组(60～79岁)137例、高龄组(≥80岁)86例. 同时选择同期来我院健康体检的血压正常老年人80例作为健康对照组. 检测比较三组24h收缩压(SBP)、舒张压(DBP)、脉压(PP)情况. 结果:动态血压比较:与健康对照组比较, 低龄组、高龄组的血压24h均值[24hSBP:(117. 63±11. 53)mmHg比(132. 04±11. 23)mmHg比(144. 26±12. 87)mmHg]、日间均值[dSBP:(119. 85±13. 20)mmHg比(134. 26±13. 52)mmHg比(146. 83±10. 64)mmHg]、夜间均值[nSBP:(115. 48±9. 74)mmHg比(128. 76±10. 85)mmHg比(141. 67±13. 42)mmHg]均显著升高(P＜0. 05或＜0. 01). 与低龄组比较, 高龄组DBP的24h均值、日间均值和夜间均值显著降低, SBP、PP的24h均值、日间均值和夜间均值均显著升高(P＜0. 05或＜0. 01). 结论:24h动态血压监测能够有效显示老年高血压患者的血压异常波动, 且年龄越大, 其血压波动越大.%Objective: To explore application of 24h ambulatory blood pressure monitoring (ABPM) in aged patients with hypertension. Methods: A total of 223 aged patients with hypertension treated in our hospital from Feb 2013 to Feb 2015 were selected. According to age, patients were divided into young age group (60～79 years, n=137) and advanced age group (≥80 years, n=86). Another 80 normotensive aged people undergoing physical examination in our hospital simultaneously were regarded as healthy control group. The 24h systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) were measured and compared between three groups. Results: Ambulatory blood pressure: compared with healthy control group, there were significant rise in 24h mean blood pressure (BP) [24hSBP: (117. 63±11. 53) mmHg vs. (132. 04±11. 23) mmHg vs. (144. 26±12. 87) mmHg], daytime BP [dSBP: (119. 85±13. 20) mmHg vs. (134. 26±13. 52) mmHg vs. (146. 83±10. 64) mmHg]and nighttime BP [nSBP: (115. 48±9. 74) mmHg vs. (128. 76±10. 85) mmHg vs. (141. 67±13. 42) mmHg]in young age group and advanced age group (P＜0. 05 or＜0. 01). Compared with young age group, there were significant reductions in 24h DBP, dDBP and nDBP, and significant rise in 24h SBP, dSBP, nSBP, 24h PP, dPP and nPP in advanced age group (P＜0. 05 or ＜0. 01). Conclusion: The 24h ABPM can effectively display the blood pressure abnormal fluctuations in aged patients with hypertension, and the higher age is, the greater blood pressure abnormal fluctuation is.