持续性、隐蔽性和白大衣3种高血压患者血压变异性分析

摘要

Objective:To explore blood pressure variability (BPV)characteristics in patients with sustained,masked hypertension (MH)and white coat hypertension (WCH).Methods:A total of 527 cases undergoing physical exami-nation in our hospital from Dec 2010 to Dec 2012 were treated as subjects.According to characteristics of blood pressure (BP),they were divided into sustained hypertension group (SH group,n= 143),MH group (n= 93), WCH group (n=86)and normal control group (NC group,n=205).CV (coefficient of variation)=BPV/mean BP.Results:BP-CV of MH group and SH group were significantly higher than that of NC group [24h systolic blood pressure (SBP)-CV: (27.73±5.36)% vs.(29.83±5.95)% vs.(17.93±4.85)%,24h diastolic blood pressure (DBP)-CV: (23.02±4.63)% vs.(22.69 ± 4.63)% vs.(14.32 ± 4.21)%,daytime (d)SBP-CV: (25.12 ± 4.79)% vs.(25.98±4.73)% vs.(14.97±4.29)%,dDBP-CV:(21.03±4.59)% vs.(20.92±4.53)% vs.(11.79 ±4.43)%,nighttime (n)SBP-CV: (21.52±4.93)% vs.(22.37±4.98)% vs.(11.57±4.19)%,nDBP-CV:(18.79±4.83)% vs.(20.09 ± 5.19)% vs.(6.98 ± 3.69)%],P < 0.01 all;however,there was no significant difference in BP-CV between WCH group and NC group,SH group and MH group (P >0.05).Conclusion:Blood pressure variability significantly rises in patients with sustained and masked hypertension,which may be one of main causes for severe target organ damage in these patients.%目的：探讨持续性，隐蔽性高血压患者与白大衣高血压患者的血压变异性（BPV）特点。方法：选择2010年12月～2012年12月在我院查体人群527例作为分析对象，并按照血压的特点全部病例被分成高血压组（SH 组，143例）、隐蔽性高血压组（MH 组，93例）、白大衣高血压组（86例）和正常对照组（NC 组，205例）。血压变异系数（CV）＝BPV/平均血压。结果：隐蔽性高血压组、持续高血压组血压 CV 较 NC 组显著增大[24h 收缩压 CV（27.73±5.36）％比（29.83±5.95）％比（17.93±4.85）％，24h 舒张压 CV（23.02±4.63）％比（22.69±4.63）％比（14.32±4.21）％，白昼收缩压 CV（25.12±4.79）％比（25.98±4.73）％比（14.97±4.29）％，白昼舒张压 CV（21.03±4.59）％比（20.92±4.53）％比（11.79±4.43）％，夜间收缩压 CV（21.52±4.93）％比（22.37±4.98）％比（11.57±4.19）％，夜间舒张压CV（18.79±4.83）％比（20.09±5.19）％比（6.98±3.69）％]，P 均＜0.01；而白大衣高血压组与 NC 组之间，持续高血压组与隐蔽性高血压组之间血压 CV 差异均无统计学意义（P ＞0.05）。结论：持续性，隐蔽性高血压患者血压变异性较为显著，这可能是这类患者靶器官损害比较严重的主要原因之一。