Rath W, Schrader J, Guhlke U, Buhr-Schinner H, Haupt A, Kramer A, Kuhn W
Universitätsfrauenklinik Göttingen.
Klin Wochenschr. 1990 Aug 2;68(15):768-73. doi: 10.1007/BF01647246.
Noninvasive 24-hour ambulatory blood pressure monitoring was performed in 17 normotensive and 19 preeclamptic pregnant women. The normotensive women showed a significant nightly decline in their systolic and diastolic blood pressure. In contrast, the preeclamptic women demonstrated either an attenuated circadian rhythm or no circadian rhythm at all. This result was even more pronounced in patients with severe hypertension, some of whom had a nocturnal increase in blood pressure in spite of being treated with antihypertensive drugs in an evening dose. The lack of nocturnal blood pressure decrease was also found 24 hours post partum. In summary, these results suggest that preeclamptic women are endangered by hypertensive emergencies mostly during the night. Therefore blood pressure controls should be extended into the night, and antihypertensive drugs should also be given in a sufficient evening dose.
对17名血压正常的孕妇和19名先兆子痫孕妇进行了无创24小时动态血压监测。血压正常的孕妇夜间收缩压和舒张压显著下降。相比之下,先兆子痫孕妇的昼夜节律要么减弱,要么完全没有昼夜节律。这一结果在重度高血压患者中更为明显,其中一些患者尽管晚间服用了降压药,但夜间血压仍会升高。产后24小时也发现缺乏夜间血压下降的情况。总之,这些结果表明,先兆子痫孕妇大多在夜间面临高血压急症的风险。因此,血压控制应延长至夜间,晚间也应给予足够剂量的降压药。