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目的观察充血性心力衰竭(CHF)的动态血压变化。方法CHF患者48例,依心功能分为A组(心功能Ⅱ级)、B组(心功能Ⅲ、Ⅳ级)和C组(晚期心力衰竭)作动态血压监测,分析各组的动态血压变化规律。结果伴随心功能的变差,收缩压均值呈下降趋势(C组0.05)。夜间平均收缩压A组较B组低,C组较B组低,A、B组与C组之间差异有统计学意义(P<0.05)。血压昼夜节律减弱或消失在A组有10例(占53%),B组有15例占(88%),C组有7例(占58%),A组和B组差异有统计学意义,但和C组比较差异无统计学意义。低血压的发生率在三组中呈升高趋势,A、B组低血压负荷接近,但与C组之间差异有统计学意义(P<0.01)。结论CHF时,血压的昼夜节律减弱或消失,并与CHF的严重程度有一定关系。晚期心力衰竭容易发生低血压,应用动态血压监测(ABPM)可有效监测晚期CHF患者治疗过程中低血压的发生及血压降低的程度。
Objective To observe the dynamic changes of blood pressure in patients with congestive heart failure (CHF). Methods Forty-eight CHF patients were divided into group A (heart function grade Ⅱ), group B (heart function Ⅲ, Ⅳ grade) and group C (heart failure) for ambulatory blood pressure monitoring. The changes of ambulatory blood pressure law. Results With the deterioration of cardiac function, mean systolic blood pressure decreased (C group 0.05). Mean systolic blood pressure at night was lower in group A than in group B, lower in group C than in group B, and statistically significant (P <0.05) in group A, group B and group C. The circadian rhythm of blood pressure weakened or disappeared in 10 cases (53%) in group A, 15 cases (88%) in group B, 7 cases (58%) in group C, and there was significant difference between group A and group B , But no significant difference compared with C group. The prevalence of hypotension was increased in all three groups. The load of hypotension was similar in groups A and B, but the difference was statistically significant (P <0.01). Conclusion CHF, circadian rhythm of blood pressure weakened or disappeared, and have a certain relationship with the severity of CHF. In advanced heart failure, hypotension is prone to occur. Using ambulatory blood pressure monitoring (ABPM) can effectively monitor the incidence of hypotension and the degree of blood pressure reduction in patients with advanced CHF.