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目的探讨动态血压监测对老年高血压患者靶器官损害的价值。方法对232例已经接受服药治疗并且至少伴有一个靶器官损害的老年高血压患者进行24h 动态血压监测,根据累及靶器官损害数目和并存心脏、脑和肾脏临床状况分为3组,结合临床资料进行统计学分析。结果靶器官损害数目与24h 平均收缩压、夜间平均舒张压、血压波动的昼夜节律异常和血压负荷增高密切相关,靶器官损害累及3个器官与累及1个器官相比差异有统计学意义(P<0.01);并存脑血管疾病组夜间平均舒张压增高显著,并存心血管疾病组和肾脏病变组的患者以24h 平均收缩压增高和血压负荷增加显著,并存临床状况的患者,血压波动的昼夜节律异常多见,并存心、脑和肾临床状况组分别与靶器官损害组相比差异有统计学意义(P<0.01)。结论 24h 平均收缩压、夜间平均舒张压和血压负荷越高,靶器官损害数目越多;血压波动的昼夜节律异常多见于并存临床状况的老年高血压患者,应用动态血压监测有助于指导临床治疗。
Objective To investigate the value of ambulatory blood pressure monitoring in target organ damage in elderly patients with hypertension. Methods 232 elderly patients with hypertension who had been treated with at least one target organ damage were monitored for ambulatory blood pressure for 24 hours. According to the number of target organs involved and the clinical status of heart, brain and kidney, the patients were divided into three groups according to the clinical data Statistical analysis. Results The number of target organ damage was closely related to 24h mean systolic pressure, nighttime mean diastolic pressure, fluctuating blood pressure circadian rhythm and increased blood pressure load. There were significant differences in target organ damage between the three organs involved and one organ involved (P <0.01). The mean night-time diastolic blood pressure increased significantly in patients with cerebrovascular disease. Patients with cardiovascular disease and nephropathy patients had higher average systolic blood pressure (24h) and significant increase in blood pressure load (p < Abnormal and common, and the heart, brain and kidney clinical status group were compared with the target organ damage group, the difference was statistically significant (P <0.01). Conclusions 24h mean systolic blood pressure, nighttime mean diastolic blood pressure and blood pressure load are higher, and the number of target organ damage is more. Circadian rhythm abnormalities of blood pressure fluctuation are more common in elderly patients with hypertension, and ambulatory blood pressure monitoring can be helpful in guiding clinical treatment .