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[高血压患者动脉压的非侵入性动态监测:在医院内还是医院外?]

[Noninvasive ambulatory monitoring of arterial pressure in hypertensive patients: inside or outside the hospital?].

作者信息

Verdecchia P, Schillaci G, Boldrini F, Guerrieri M, Gatteschi C, Benemio G, Porcellati C

机构信息

Divisione Medicina Generale, Ospedale Regionale R Silvestrini, Perugia.

出版信息

Cardiologia. 1990 Nov;35(11):911-7.

PMID:2099245
Abstract

To investigate whether hospitalization may influence the circadian rhythm of blood pressure (BP), 15 untreated patients with essential hypertension underwent noninvasive ambulatory blood pressure monitoring twice, at home and in the hospital, in a random order, 11 days apart. During the hospital session, which took place on the ninth day of hospitalization, patients were allowed to move freely in the hospital area, to receive visits by friends and relatives and to engage in social activities with other inpatients. Home sessions were performed during a usual working day in 14 of 15 patients. Average 24-hour systolic/diastolic BP was 151/93 mmHg (DS 19/10) at home and 154/93 mmHg (DS 21/7) in the hospital; average daytime (6am-10pm) values were 155/97 mmHg (DS 19/10) at home and 157/96 mmHg (DS 20/5) in the hospital; average night-time (10pm-6am) values were 146/88 mmHg (DS 21/12) at home and 150/89 mmHg (DS 23/10). These values did not show any statistical differences (analysis of variance) due to status (home vs hospital), period or sequence. The hourly BP averages of the hospital recording did not differ significantly from the corresponding averages of the home recording. The correlation between hospital and home 24-hour averages of systolic and diastolic BP was close (r = 0.87 and r = 0.78, respectively; p less than 0.01). The chronobiological analysis (single cosinor) showed a statistically significant circadian rhythm of systolic BP in 10/15 patients at home and in 8/15 patients in the hospital (p = NS), and a statistically significant rhythm of diastolic BP in 9/15 patients at home and in 10/15 patients in the hospital (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为研究住院是否会影响血压(BP)的昼夜节律,15例未经治疗的原发性高血压患者在家中和医院接受了两次无创动态血压监测,监测顺序随机,间隔11天。在住院第9天进行的医院监测期间,患者可在院区自由活动、接受亲友探视并与其他住院患者进行社交活动。15例患者中的14例在正常工作日进行了家庭监测。在家时平均24小时收缩压/舒张压为151/93 mmHg(标准差19/10),在医院时为154/93 mmHg(标准差21/7);白天(上午6点至晚上10点)平均血压值在家时为155/97 mmHg(标准差19/10),在医院时为157/96 mmHg(标准差20/5);夜间(晚上10点至上午6点)平均血压值在家时为146/88 mmHg(标准差21/12),在医院时为150/89 mmHg(标准差23/10)。这些值在状态(在家与在医院)、时期或顺序方面未显示出任何统计学差异(方差分析)。医院记录的每小时平均血压与家庭记录的相应平均值无显著差异。医院和家庭24小时收缩压和舒张压平均值之间的相关性密切(分别为r = 0.87和r = 0.78;p小于0.01)。时间生物学分析(单余弦法)显示,在家中10/15例患者和在医院8/15例患者的收缩压有统计学显著的昼夜节律(p = 无统计学意义),在家中9/15例患者和在医院10/15例患者的舒张压有统计学显著的节律(p = 无统计学意义)。(摘要截短至250字)

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