https://scholars.lib.ntu.edu.tw/handle/123456789/187947
標題: | 中國人之白袍高血壓的研究(II) | 其他標題: | Study on White Coat Hypertension in Chinese (II) | 作者: | 曾淵如 | 關鍵字: | 高血壓;目標器官合併症;移動式血壓;隨機血壓;hypertension;target organ damage;ambulatory blood pressure;casual blood pressure | 公開日期: | 1999 | 出版社: | 臺北市:國立臺灣大學醫學院內科 | 摘要: | 在290 名有輕度至中度高血壓病人進行 血壓參數在預測高血壓目標器官合併症的能 力。 隨機血壓測量是利用傳統式水銀柱血壓 計測定。24 小時移動式血壓記錄是利用Del Mar Avionics 公司之Model 1990 Pressurometer IV 型。高血壓之診斷依據世界 衛生組織之條件。高血壓目標器官合併症是依 據心電圖、胸部X 光、尿液分析及眼底檢查的 評估。 顯然,在高血壓目標器官合併症的預測 上,移動式血壓參數優於隨機血壓之條件。在 移動式血壓參數中,移動式血壓值高於隨機血 壓值,逆轉之血壓週期變化型態,及血壓夜間 未降等在目標器官合併的預測上有用。在心電 圖之左心室肥厚的預測上,移動式收縮壓平均 值高於隨機收縮壓之敏感度為23.8%,特殊度 為97.6%,正預測值為79.2%,而負預測值 為77.1%;在舒張壓之比較的四項預測值分別 為31.3%,88.6%,51%及77.2%。收縮壓的 逆轉之血壓週期型態之四項預測值分別為 31.3%,88.6%,51%及77.2%;其舒張壓的 相對參數之四項預測值分別為32.5%, 87.1%,49.1%及77.2%。收縮壓夜間未降之 四項預測值分別為67.5%,51.4%,34.6%及 80.6%;其舒張壓的相對參數之四項預測值分 別為75%,33.2%,30%及77.8%。上述三 項血壓參數在胸部X 光診斷之左心室肥厚、蛋 白尿及眼底病變的預測也有相似的結果。 本研究顯示在高血壓目標器官合併症之 預測上,移動式血壓參數優於隨機血壓,而血 壓的分佈型態比血壓的程度有較高的預測 值。 The ability of blood pressure parameters to predict hypertensive target organ complications was evaluated on 290 consecutive patients with mild to moderate essential hypertension. Casual blood pressure (CBP) measurements were obtained by standard sphygmomanometric methods during the day at an outpatient clinic. Twenty-four hour ambulatory blood pressure (ABP) recording with Del Mar Avionics, Model 1990 Pressurometer IV System was performed 1 to 3 days after CBP measurements were taken. The blood pressure level for hypertension was adopted from WHO criteria. The target organ complications of hypertension were assessed by ECG, chest x-ray, urinalysis and eye-fundus examinations. The ABP parameters are shown to be superior to CBP criteria for hypertension in predicting hypertensive target organ complications. Among the ABP parameters, a comparison between CBP and ABP levels, reversed circadian patterns of BP and nocturnal non-reduction of BP are found to be useful in predicting the target organ complications. With regard to the predictive value for ECG evidence of left ventricular hypertrophy (LVH), a SBP average greater than casual SBP had a sensitivity of 23.8%, specificity of 97.6%, a positive predictive value of 79.2%, and a negative predictive value of 77.1%. Their counterparts in DBP gave the corresponding values of 31.3%, 88.6%, 51.0% and 77.2%, respectively. A reversed circadian pattern of SBP achieved the corresponding values of 31.3%, 88.6%, 51% and 77.2%, respectively. Their counterparts of DBP obtained the corresponding values of 32.5%, 87.1%, 49.1% and 77.2%, respectively. The nocturnal non-reduction of SBP had the corresponding values of 67.5%, 51.4%, 34.6% and 80.6%, respectively. Their counterparts in DBP obtained the corresponding values of 75%, 33.2%, 30% and 77.8%, respectively. Similar results were found in the predictive values of the above-mentioned blood pressure parameters for LVH on chest x-ray, proteinuria and retinopathy. The study has revealed the superiority of ABP parameters to CBP values in predicting the hypertensive target organ complications. The distribution patterns of BP have also been shown to have higher predictive values for hypertensive target organ complication than those of BP levels. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/23427 | 其他識別: | 882314B002290 | Rights: | 國立臺灣大學醫學院內科 |
顯示於: | 醫學系 |
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882314B002290.pdf | 84.75 kB | Adobe PDF | 檢視/開啟 |
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