摘要
目的 观测分析航海人员中高血压与正常血压者的 2 4h动态血压 (2 4h ABP)及偶测血压 (CBP) ,以探讨 CBP与动态血压监测 (ABPM)之间的相关性。方法 用标准水银柱式血压计测坐位左上臂血压 3次 ,取平均值作为 CBP的收缩压 (SBP)、舒张压 (DBP)和平均动脉压 (MAP)。用 ABPM获得2 4h动态血压的 2 4h SBP、2 4h DBP和 2 4h MAP,以及日间平均动态血压 (d ABP)的 d SBP、d DBP和d MAP,与夜间平均动态血压 (n ABP)的 n SBP、n DBP和 n MAP。结果 高血压组 CBP的平均 SBP、DBP、MAP均高于 d ABP和 2 4h ABP(P均 <0 .0 1) ;CBP与 d ABP间的 SBP、DBP、MAP均值的差值分别为13.2 ,10 .0和 11.6 m m Hg,并均明显高于血压正常组的两者差值 (P<0 .0 1)。 CBP法与血压负荷值法[d SBP或 d DBP>12 %或 (和 ) n SBP或 n DBP>15 % ]诊断高血压的一致性为 95 % ,而后者诊断的特异性为 99% ,敏感性为 84% ,白大衣性高血压 (WCH)发生率为 16 % ;CBP法与 d ABP法 (≥ 135 / 85 mm Hg)诊断高血压的一致性为 76 % ,而后者诊断的特异性为 84% ,敏感性为 5 4% ,WCH发生率为 45 .6 %。结论 ABPM的负荷值法诊断高血压与 CBP的一致性及其诊断的敏感性与特异性均高于 d ABP法 。
Objective To study the correlation between casual blood pressure(CBP) and 24 hour ambulatory blood pressure(24h ABP) in seamen with hypertension or normal BP. Methods Standard mercury sphygmomanometer was used to take the sitting blood pressure from left arm for three times and the mean values of this CBP which consist of systolic blood pressure(SBP),diastolic blood pressure(DBP) and mean arterial pressure(MAP) were calculated. The 24h ABP, the mean blood pressure in the daytime (dABP) and the mean blood pressure in the nighttime(nABP) were obtained by a 24 hour ambulatory blood pressure monitoring device. Results In the hypertension group, all the mean values of CBP including SBP、DBP and MAP were significantly higher than those of dABP and 24h ABP( P <0 01). The differences in the means of SBP,DBP and MAP between CBP and dABP were 13.2,10.0 and 11.6 mmHg respectively in the hypertension group, and they were significantly higher than those in the normal BP group. High blood pressure was diagnosed by two different methods: the one (CBP method) was that the blood pressure of CBP should ≥140/90 mmHg, the other (BP load method) was that the blood pressure loads should satisfy the predefined criteria of dSBP or dDBP>12% and(or) nSBP or nDBP>15%. The consistency of these two diagnostic methods was 95%, and the specificity, the sensitivity and the incidence of white coat hypertension(WCH) of the BP load method were 99%, 84% and 16% respectively. When the dABP method(≥135/85 mmHg) was used instead of BP load method, then the consistency was 76%, and the specificity, the sensitivity and the incidence of WCH of the dABP method were 84%,54% and 45.6% respectively. Conclusions The consistency with CBP method, and the specificity and sensitivity of diagnosis with BP load method were all superior to those with dABP method. It was suggested that the BP load method might be more reliable in clinical practice.
关键词
航海人员
动态血压
偶测血压
白大衣性高血压
Seamen Ambulatory blood pressure Casual blood pressure White coat hypertension
