高血压病患者的中心动脉压可能存在白大衣现象

发布时间：2018-02-19 21:58

本文关键词： 中心动脉压白大衣现象高血压　出处：《福建医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:探讨高血压病患者中心动脉压是否存在白大衣现象。方法:共收集44位根据诊室血压(OBP)新诊断的高血压病患者,年龄在19-80岁之间,其中男性20名,女性24名。所有患者均被要求自初诊第一日起自测家庭血压1周。在初诊当日,所有患者均无创测量中心动脉压(CAP)及脉搏波分析。根据家庭血压(HBP)结果将所有患者分为两组:持续性高血压组(SHT组,n=28)和白大衣高血压组(WCH组,n=16);根据OBP和HBP之间的差值,再将SHT组分为:白大衣效应组(WCE组,n=15)和非白大衣效应组(NWCE组,n=13)。计算各组中心动脉收缩压(CASP)与HSBP的差值(CHSBP),作为判断中心动脉压是否存在白大衣现象的指标。结果:(1)分别计算各组间的OSBP、检查室收缩压(ESBP)、HSBP与CASP的差值,分别用OCSBP、ECSBP、HCSBP表示。结果发现,只有HCSBP在WCH组较SHT组低(-1.97±14.54比7.07±11.18 mm Hg,p=0.026)、在WCE组明显小于NWCE组(2.33±8.59比12.54±11.60 mm Hg,p=0.013)。而OCSBP、ECSBP在各组间无显著差异(p0.05)。(2)为进一步了解各种血压测量方式的白大衣效应程度,我们分别求得OSBP、ESBP、CASP与HSBP的差值,分别用OHSBP、EHSBP、CHSBP表示。结果发现在WCH组OHSBP、EHSBP、CHSBP均明显高于SHT组(OHSBP:21.88±11.85比11.98±11.01 mm Hg,p=0.008;EHSBP:10.97±13.55比2.28±11.33 mm Hg,p=0.028;CHSBP:1.97±14.54比-7.07±11.18 mm Hg,p=0.026)。在校正完身高、BMI、年龄、PWV、ABI、早发心血管疾病家族史后,上述各差异仍具有统计学意义(p0.05)。同时,不论在WCH组或是SHT组均可观察到OHSBPEHSBPCHSBP(p0.05)。(3)相关分析发现CASP与同步测量的外周收缩压密切相关(r=0.91,p0.001)。结论:高血压病患者中心动脉压可能存在白大衣现象,其白大衣效应程度,即血压升高的幅度,低于诊室和检查室血压的白大衣效应程度。
[Abstract]:Objective: to investigate the existence of white coat in central arterial pressure in patients with hypertension. Methods: a total of 44 newly diagnosed hypertension patients, aged between 19 and 80 years, including 20 men, were collected according to the blood pressure in the clinic. 24 women. All patients were asked to test their blood pressure for one week from 1st. All the patients were divided into two groups according to the results of family blood pressure (HBP): continuous hypertension group (SHT group) and white coat hypertension group (WCH group), according to the difference between OBP and HBP. The SHT components were divided into white coat effect group and non-white coat effect group. The difference between central arterial systolic pressure and HSBP was calculated as an index to judge the existence of white coat phenomenon. The difference between OSBP and CASP was calculated. The results showed that only HCSBP in WCH group was lower than that in SHT group (-1.97 卤14.54 vs 7.07 卤11.18 mm), and in WCE group was significantly smaller than that in NWCE group (2.33 卤8.59 vs 12.54 卤11.60 mm). We obtained the difference between HSBP and ESBP, respectively. The results showed that the difference between WCH group and HSBP group was significantly higher than that in SHT group (21.88 卤11.85 vs 11.98 卤11.01 mm vs 11.98 卤11.01 mm vs 11.98 卤11.01 mm vs 10.97 卤13.55 vs 2.28 卤11.33 mm vs 2.28 卤11.33 mm vs 1.97 卤14.54 vs -7.07 卤11.18 mm). The above differences are still statistically significant (p 0.05). At the same time, OHSBPEHSBPCHSBP (p0.05) correlation analysis showed that CASP was closely related to the measured peripheral systolic blood pressure (CASP). Conclusion: the central arterial pressure of essential hypertension patients may have white coat phenomenon and the degree of white coat effect. The range of elevated blood pressure was lower than the white coat effect of blood pressure in the clinic and examination room.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1

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