中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2013年
9期
734-737
,共4页
张煜%刘建彬%曹晓佩%邓婉萍%赵晓娟%伍基颜%黄知敏%李延兵
張煜%劉建彬%曹曉珮%鄧婉萍%趙曉娟%伍基顏%黃知敏%李延兵
장욱%류건빈%조효패%산완평%조효연%오기안%황지민%리연병
醛固酮增多症,原发性%醛固酮瘤%动态血压
醛固酮增多癥,原髮性%醛固酮瘤%動態血壓
철고동증다증,원발성%철고동류%동태혈압
Hyperaldosteronism,primary%Aldosterone producing adenoma%Ambulatory blood pressure monitoring
目的 探讨醛固酮瘤患者血压昼夜节律特点.方法 对2010年1月至2012年12月收治的20例醛固酮瘤(APA)患者(APA组)、25例原发性高血压(EH)患者(EH组),行24 h动态血压监测,评价APA患者全天血压变化,分析APA患者血压昼夜节律特点和影响因素.结果 APA组BMI、血清钾水平、立位肾素活性、血管紧张素Ⅱ水平低于EH组,而血清钠、立位醛固酮水平高于EH组,差异有统计学意义(t值分别为-2.31、-5.68、-4.39、-2.43、2.72和2.79,均P＜0.05).APA组夜间平均收缩压高于EH组[(140±20)与(126±19)mm Hg(1 mm Hg=0.133 kPa),=2.32,P＜0.05],两组平均血压、血压变异性指标、夜间血压下降幅度与百分率差异均无统计学意义(P＞0.05).两组患者杓形血压的比例差异无统计学意义[20％ (4/20)与28％(7/25),x2=1.43,P＞0.05].以性别、年龄、高血压病程、高血压家族史、BMI、血清钠水平、血清钾水平、立位血浆醛同酮及肾素水平为自变量,以杓形血压作为因变量进行多元logistic回归分析,上述指标与非杓形血压无独立相关性.结论 APA患者发生昼夜血压节律消失的比例以及高血压特点与EH患者之间无明显的差异.
目的 探討醛固酮瘤患者血壓晝夜節律特點.方法 對2010年1月至2012年12月收治的20例醛固酮瘤(APA)患者(APA組)、25例原髮性高血壓(EH)患者(EH組),行24 h動態血壓鑑測,評價APA患者全天血壓變化,分析APA患者血壓晝夜節律特點和影響因素.結果 APA組BMI、血清鉀水平、立位腎素活性、血管緊張素Ⅱ水平低于EH組,而血清鈉、立位醛固酮水平高于EH組,差異有統計學意義(t值分彆為-2.31、-5.68、-4.39、-2.43、2.72和2.79,均P＜0.05).APA組夜間平均收縮壓高于EH組[(140±20)與(126±19)mm Hg(1 mm Hg=0.133 kPa),=2.32,P＜0.05],兩組平均血壓、血壓變異性指標、夜間血壓下降幅度與百分率差異均無統計學意義(P＞0.05).兩組患者杓形血壓的比例差異無統計學意義[20％ (4/20)與28％(7/25),x2=1.43,P＞0.05].以性彆、年齡、高血壓病程、高血壓傢族史、BMI、血清鈉水平、血清鉀水平、立位血漿醛同酮及腎素水平為自變量,以杓形血壓作為因變量進行多元logistic迴歸分析,上述指標與非杓形血壓無獨立相關性.結論 APA患者髮生晝夜血壓節律消失的比例以及高血壓特點與EH患者之間無明顯的差異.
목적 탐토철고동류환자혈압주야절률특점.방법 대2010년1월지2012년12월수치적20례철고동류(APA)환자(APA조)、25례원발성고혈압(EH)환자(EH조),행24 h동태혈압감측,평개APA환자전천혈압변화,분석APA환자혈압주야절률특점화영향인소.결과 APA조BMI、혈청갑수평、립위신소활성、혈관긴장소Ⅱ수평저우EH조,이혈청납、립위철고동수평고우EH조,차이유통계학의의(t치분별위-2.31、-5.68、-4.39、-2.43、2.72화2.79,균P＜0.05).APA조야간평균수축압고우EH조[(140±20)여(126±19)mm Hg(1 mm Hg=0.133 kPa),=2.32,P＜0.05],량조평균혈압、혈압변이성지표、야간혈압하강폭도여백분솔차이균무통계학의의(P＞0.05).량조환자표형혈압적비례차이무통계학의의[20％ (4/20)여28％(7/25),x2=1.43,P＞0.05].이성별、년령、고혈압병정、고혈압가족사、BMI、혈청납수평、혈청갑수평、립위혈장철동동급신소수평위자변량,이표형혈압작위인변량진행다원logistic회귀분석,상술지표여비표형혈압무독립상관성.결론 APA환자발생주야혈압절률소실적비례이급고혈압특점여EH환자지간무명현적차이.
Objective To investigate the circadian blood pressure pattern in patients with aldosterone-producing adenoma.Methods Circadian variation of blood pressure was assessed by 24-h ambulatory blood pressure monitoring (ABPM) in 20 patients with adrenal aldosterone-producing adenoma (APA) and 25 patients with essential hypertension (EH).Results Compared to EH group,the body mass index,serum potassium concentration,upright plasma renin activity and angiotensin Ⅱ levels in APA group were lower and the serum sodium concentration and upright plasma altosterone concentration were higher (all P ＜0.05).The night-time systolic blood pressure in APA group was higher than that in EH group [(140 ±20) vs.(126±19) mm Hg(l mm Hg=0.133 kPa),t=2.32,P＜0.05]; there were no differences in day-night blood pressure differences between patients with APA and those with EH.Proportions of patients with dipper blood pressure were also comparable between the two groups [20％ (4/20) vs.28％ (7/25),x2 =1.43,P ＞ 0.05].Multivariate Logistic regression analysis showed no independent predictors for nondipper circadian blood pressure pattern.Conclusion There are no significant differences in proportion of nondipper circadian blood pressure pattern and blood pressure characteristics between APA and EH patients.
