Cugini P, Di Palma L, Ciamei A, De Luca A, Leone G, Pelosio A
Istituto di Semeiotica e Metodologia Medica, Università La Sapienza, Roma.
Recenti Prog Med. 1994 Apr;85(4):257-64.
The monodiagnosis of hypertension via ambulatory (A) blood pressure (BP) monitoring (M) is erroneous by definition. Its use has to be substituted by the chronodiagnosis. Because of the lack of an international standardization, the BP chronobiologic reference limits have to be computed on a small sample size. For this compilation, it is, however, unavoidable the recruitment of normotensive subjects using the WHO's fixed limits. These chronobiologic standards are by principle contaminated by false negatives and need a bayesian validation. Such a depuration has been made by reclassifying each subject using the BP time-qualified standards. A secondary sample was constituted on the true normotensive reclassified. This sample provided the a posteriori reference standards for BP. The bayesian chronobiologic reference standards seem to be the limits with which the chronodiagnosis of hypertension can be suitably done via ABPM.
通过动态血压监测进行高血压的单一诊断从定义上来说就是错误的。其应用必须被时间诊断所取代。由于缺乏国际标准化，血压时间生物学参考限值必须基于小样本量来计算。然而，对于此次汇编，使用世界卫生组织的固定限值招募血压正常的受试者是不可避免的。这些时间生物学标准原则上受到假阴性的影响，需要进行贝叶斯验证。通过使用血压时间限定标准对每个受试者重新分类来进行这种净化。在重新分类为真正血压正常的受试者中构成了一个次级样本。这个样本提供了血压的后验参考标准。贝叶斯时间生物学参考标准似乎是通过动态血压监测能够适当地进行高血压时间诊断的限值。
