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目的:研究高原高血压的动态血压特点与变化规律。方法:采用国产MPG1型动态血压监测仪,对进驻海拔4800m高原施工、平原医学体检为正常血压的36例男性高原高血压患者,进行标准化动态血压检测。结果:高原高血压以白昼血压和舒张压(DBP)升高为主,DBP均值在全天、白昼均达高血压标准而收缩压(SBP)只在白昼达到标准,夜间二者均下降到正常范围;单纯舒张期高血压所占比例显著高于单纯收缩期高血压(P<0·01),其昼夜节律仍呈杓形变化曲线但夜间下降百分率仍<10%,心率与DBP、SBP、平均压及心率×血压均呈正相关关系(均P<0·01)。结论:高原高血压的动态变化节律主要受机体耗氧程度的影响,即与低氧性增压反应有关,其防治重点仍应放在减少氧耗、改善低氧这一核心问题上。
Objective: To study the characteristics and changes of ambulatory blood pressure in patients with high altitude hypertension. Methods: The home-made MPG1 ambulatory blood pressure monitor was used to measure the ambulatory blood pressure in 36 male plateau hypertensive patients who were stationed at an altitude of 4800m and plain medical examination was normal blood pressure. Results: The plateau hypertension was dominated by the increase of daytime blood pressure and diastolic blood pressure (DBP). The mean of DBP reached the standard of high blood pressure during the whole day and day, while the systolic blood pressure (SBP) reached the standard only in the daytime and both decreased to normal at night The proportion of simple diastolic hypertension was significantly higher than that of isolated systolic hypertension (P <0.01). The circadian rhythm was still dipper-shaped but the percentage of nighttime declination was still <10%. The correlation between heart rate and DBP, SBP, Mean pressure and heart rate × blood pressure showed a positive correlation (all P <0.01). Conclusion: The rhythm of high altitude hypertension is mainly affected by the degree of oxygen consumption of the body, that is, hypoxia-induced hyperuricemia. The focus of prevention and treatment should still be on the core issue of reducing oxygen consumption and improving hypoxia.