Meyer-Sabellek W, Schulte K L, Distler A, Gotzen R
Abteilung für allgemeine Innere Medizin und Nephrologie, Klinikum Steglitz, Freie Universität Berlin.
Z Kardiol. 1991;80 Suppl 1:1-7.
Noninvasive automatic 24-h indirect ambulatory monitoring of blood pressure (ABPM) and heart rate has been performed in more than 2000 subjects from 1983-1990 using 12 different devices. According to the requirements of national validation authorities (e.g. AAMI, PTB and BHS) only four devices have passed at least two protocols. These monitors were equipped with auscultatory and/or oscillometric devices; they provided accurate readings and were repeatedly used up to eight times in some patients. Up to 100 data points per 24-h provided diurnal blood pressure profiles for over 91% of the patients in clinical and non-clinical situations. Early identification of borderline hypertensives at risk and detailed information on the efficacy of different anti-hypertensive regimes may in part justify the high costs of the monitors. Although sleep disturbance continued in more than 20% of investigated patients, the new lighter, quieter monitors (e.g., SL 90207, 380 g) were well received by patients and nurses. In the future, simultaneous registration with 24-h ECG may help in identifying the effects of different antihypertensive therapies on blood pressure variabilities and rhythmicity of the heart rate. The cost-benefit-ratio and the prognostic importance have yet to be defined.
1983年至1990年期间,使用12种不同设备对2000多名受试者进行了无创自动24小时间接动态血压(ABPM)和心率监测。根据国家验证机构(如AAMI、PTB和BHS)的要求,只有四种设备至少通过了两项协议。这些监测仪配备了听诊和/或示波装置;它们提供了准确的读数,并且在一些患者中被反复使用多达八次。每24小时多达100个数据点为91%以上的临床和非临床患者提供了昼夜血压曲线。早期识别有风险的临界高血压患者以及不同抗高血压治疗方案疗效的详细信息,可能在一定程度上证明了监测仪高昂成本的合理性。尽管超过20%的受调查患者仍存在睡眠障碍,但新型更轻便、更安静的监测仪(如SL 90207,380克)受到了患者和护士的好评。未来,与24小时心电图同时记录可能有助于确定不同抗高血压治疗对血压变异性和心率节律性的影响。成本效益比和预后重要性尚待确定。