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題名 | Diurnal Blood Pressure Changes in Primary Aldosteronism--A Study of Ambulatory Blood Pressure Monitoring and Neurohormonal Changes=原發性醛類酯醇過多症日夜血壓變化: 運用攜帶式二十四小時血壓監視研究與神經荷爾蒙之關係 |
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作者 | 白培英; 周湘臺; 鄒吉生; 陳清助; 王廷輔; Pai, Pei-ying; Chou, Hsiang-tai; Tsou, Shi-sheng; Chen, Ching-chu; Wang, Ting-fu; |
期刊 | 中臺灣醫學科學雜誌 |
出版日期 | 19980300 |
卷期 | 3:1 1998.03[民87.03] |
頁次 | 頁27-33 |
分類號 | 415.382 |
語文 | eng |
關鍵詞 | 24小時血壓監視; 次發性高血壓; 神經荷爾蒙; Ambulatory BP monitor; Secondary hypertension; Neurohormonal; |
中文摘要 | 為了解次發性高血壓患者之血壓變化與標的器官傷害之關係並評估其神經荷爾蒙之變化,經由非侵襲性之血壓監視器測得異常之血壓變化,作為臨床上篩檢次發性高血壓之診斷工具,並經由神經荷爾蒙之變化,了解次發性高血壓異常之血壓變化機轉,期能尋求更有效治療方式。本研究即利用非侵襲性之24小時血壓監視器,記錄在一般活動下之次發性高血壓患者24小時之血壓變化,並檢驗其血中不同時段神經荷爾蒙之濃度對血壓值變化及對標的器官傷害的影響。本計畫取樣自門診異常高血壓患者經檢查有次發性之原因包括原發性醛類酯醇過多症或慢性腎衰竭之病人安排接受24小時血壓監視,心臟超音波檢查及神經荷爾蒙之檢驗。在原發性醛類酯醇過多症之病人,白天及夜晚之血壓都比原發性高血壓患者高(白天SBP:147 ± 16 vs 125 ± 11mmHg, DBP:96 ± 18 vs 85 ± 8mmHg;夜晚SBP:142 ± 23 vs 118 ± 13mmHg,DBP 91 ± 24 vs 81 ± 9mmHg,p<0.05 ),在慢性腎衰竭之病人與原發性高血壓患者比較,他們的日間血壓有較顯著之差異。在原發性醛類酯醇過多症之病人,夜晚之收縮壓下降之幅度並不顯著,不見有日夜之變化。因此,對於夜間血壓下降不顯著之病人應該更仔細去追查及治療潛在之次發性病因。 |
英文摘要 | The study was aimed to investigate the relationship between the 24-hour blood pressure and neurohormonal change in patients with secondary hypertension. Circadian blood pressure variation was studied in patients with chronic renal failure and primary aldosteronism. Ambulatory blood pressure was monitored every 10 minutes during daytime and every 30 minutes during nighttime. The daytime and nighttime systolic/diastolic blood pressures (SBP/DBP) in patients with primary hyperaldosteronism were significantly higher than those with primary hypertension (SBP:147 ± 16 vs 125 ± 11 mmHg, daytime; 142 ± 23 vs 118 ± 13 mmHg, nighttime; DBP:96 ± 18 vs 85 ± 8 mmHg, daytime; 91 ± 24 vs 81 ± 9 mmHg, nighttime). In the renal form of secondary hypertension, the blood pressure did not reveal a significant difference with diurnal change in comparison with primary hypertension. The reduction in nocturnal blood pressure was less in primary hyperaldosteronism than in primary hypertension. Insufficient decrease of blood pressure during nighttime may warrant further investigation to diagnose secondary hypertension. |
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