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目的研究妊娠高血压综合征(妊高征)患者动态血压的变化。方法对116例妊高征患者进行24 h动态血压监测(ABPM)。结果重度妊高征患者24 h平均血压和日、夜平均血压均明显高于轻、中度妊高征患者(P<0.05);中、重度妊高征患者非杓型改变比轻度妊高征患者明显增多(P<0.01)。重度妊高征24 h尿蛋白定量、生后1 m in Apgar评分<8分者比轻、中度妊高征明显增多(P<0.05)。结论轻度妊高征大部分有昼夜节律变化(呈杓型),治疗不必用药,以休息为主;中、重度妊高征患者昼夜节律变化不明显(呈非杓型),夜间抗高血压药物治疗应足量。ABPM对妊高征患者的诊断分度及制订个体化治疗有积极的指导意义。
Objective To study the changes of ambulatory blood pressure in patients with pregnancy induced hypertension (PIH). Methods 116 patients with PIH were monitored by ambulatory blood pressure monitoring (ABPM). Results The average blood pressure at 24 hours and the average daily blood pressure at day 24 were significantly higher in patients with severe PIH than in those with mild or moderate PIH (P <0.05). The non-dipper changes in patients with moderate and severe PIH were significantly higher than those with mild PIH Sign of patients was significantly increased (P <0.01). Severe pregnancy-induced hypertension 24 h urinary protein, 1 m in neonatal Apgar score <8 points were significantly higher than mild to moderate PIH (P <0.05). Conclusion Most of mild pregnancy-induced hypertension have circadian rhythmic changes (dipper type), and no rest for medication. The circadian rhythm of moderate and severe PIH is not obvious (non-dipper type), nighttime antihypertensive Medication should be adequate. ABPM has a positive guiding significance for the diagnosis of PIH patients and the development of individualized treatment.