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老年脑梗塞患者恢复期血压的昼夜变化 |
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庄作民 郑杭玲 边平达 刘元标 倪建芳 王洁婷
摘要 目的：观察老年脑梗塞患者恢复期血压昼夜变化的方式及可能影响的因素。方法：应用24小时血压监测仪测定45例老年半球梗塞患者昼夜血压变化，并与年龄、性别、血压情况相似的老年非脑梗塞者进行比较。结果：老年脑梗塞患者恢复期的昼夜平 均收缩压和舒张压与对照组相比无显著差异，而昼夜收缩压相对差小于对照组(P＜0.05)，原有高血压史的脑梗塞患者的昼夜收缩压相对差(P＜0.01)，昼夜收缩压百分率(P＜0.05)，昼夜舒张 压相对差(P＜0.05) 显著低于对照组。结论：提示有高血压史的脑梗塞患者恢复期的血压昼夜变化仍有异常。
关键词 老年；脑梗塞；高血压
Day and night blood pressure change with cerebral infarction of the age patients during convalescence
ZHUANG Zuomin, ZHENG Hangling, BIAN Pingda, et al
Chinese Journal of Rehabilitation Medicine,1999,14(5):216～218
Abstract Objective:To investigate the pattern and probable factors of day and night BP change with cerebral infarction of the aged patien ts during convalescence.Method:Fortyfive hemispheric infar cti on patients were performed 24 hour BP monitoring (Spacelabs 90207) an d compared with age,sex, BP matched control group of 45 subjects. Result:The systolic pressure(SP)、diastolic pressure(DP)、day SP(DSP)、night SP(NSP)、day DP(DDP)、night DP(NDP) were not significant different between the two groups.The hemispheric infarction had significant reducing change of SP of the day and night(P<0.05), and the patients with hypert ension had significant reducing of SP change (P<0.01) as well.Comparison of SP of the day and night percentage s howed P<0.05,and DP of day and night change (P<0.05). Conclusion:The day and night BP change is abnormal in the aged cerebral infarction patients with hypertension during convalescence.
Author′s" address Wangjiangshan Hospital of Zhejiang Province, H angzhou,310024
Key words The older; Cerebral infarction; Hypertension
正常人的血压昼夜变化，以日间活动时最高，如排除活动、情绪等因素的影响，则以傍晚时最高，夜间血压下降，睡眠时进一步下降，多数以清晨临醒前为最低。血压昼夜变化曲线，反映了人体的正常调节机制，而在高血压病患者，尤其是有严重靶器官损害（如左室肥厚、脑血管病、缺血性心脏病）的患者，血压昼夜变化曲线常有异常改变。Verdecchia等报道〔1〕，在1100例高血压病患者的24小时血压动态监测中，血压变化曲线呈非长勺状（nondippers）和倒长勺状（reverse dippers）者显著高于非高血压者，有此类表现者的远期死亡率较高，女性非长勺状者较长勺状者心血管死亡率高。最近，Dawson等报道各类脑[1] [2] 下一页
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