Abstract：Objective To investigate the application of ambulatory blood pressure monitoring(ABPM) to medical evaluation of aircrew with early hypertension.Methods According to the 24-hour mean value of ambulatory blood pressure, 32 aircrews with office hypertension were divided into ABPM hypertension group and white coat hypertension (WCH) group, with 30 healthy male pilots as the control group.Results 17 cases (53.13%) were diagnosed with grade 1 hypertension by ABPM and 15 cases(46.88%) with white coat hypertension. Night systolic blood pressure fall rate (nSBPF) and night diastolic blood pressure fall rate (nDBPF) were similar in these three groups. There was statistically significant difference between the three groups in 24 h systolic blood pressure load (24 h SBPL) and 24h diastolic blood pressure load (24 h DBPL).Conclusion ABPM hypertension group and WCH group can maintain normal the circadian rhythm. 24 h SBPL and 24 h DBPL are much more sensitive indexes for classifying the three groups. ABPM can be used as an important reference index of early diagnosis,treatment and medical evaluation of aircrews with hypertension.
王海燕，姚向荣，袁博丽. 飞行人员早期高血压病动态血压分析及医学鉴定[J]. 解放军预防医学杂志, 2016, 34(4): 475-477.
WANG Haiyan, YAO Xiangrong, YUAN Boli. Application of Ambulatory Blood Pressure Monitoring to Medical Evaluation of Aircrew with Early Hypertension. Journal of Preventive Medicine of Chinese People's Liberation Army, 2016, 34(4): 475-477.
(1) 张丹,段付军,张宁玲,等.2003-2012年本院飞行人员住院疾病谱分析(J).解放军医学院学报,2014,35(4):322. (2) 刘玉华,郑军,翟丽红,等.2007-2010年度军事飞行人员住院疾病谱分析(J).军医进修学院学报,2012,33(12):1224. (3) 汪斌如,徐先荣,翟丽红.不同机种飞行人员停飞疾病谱的比较研究 (2006-2012) (J).解放军医学院学报,2014,35(4):308. (4) HODGKINSON J,MANT J,MATTIN U,et al. Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension:systematic review(J).BMJ,2011,24:342. (5) WHITE WB,GULATI V.Managing hypertension with ambulatory blood pressure monitoring(J). Curr Cardiol Rep,2015,17(2) :2. (6) 肖文成,巨雅平,牛凯.动态血压监测对高血压诊治的临床意义(J).实用心脑肺血管病杂志,2014(4):91. (7) 中国高血压防治指南修订委员会. 中国高血压防治指南2010(J).中华高血压杂志,2011,19(8):701. (8) 丹宇,卜祥雷,黄亚薇,等.动态血压负荷对高血压评价的探讨(J).中华心血管杂志,1996,24(4):264. (9) SMOLENSKY M H,HERMIDA R C,AYALA D E,et al.Administration-time-dependent effects of blood pressure-lowering medicines:basis for the chronotherapy of hypertension (J).Blood Press Monit,2010,15(4):173. (10) AYALA D E,HERMIDA R C,MOJON A ,et al.Cardiovascularrisk of resistant hypertension:dependence on treatment-time regimen of blood pressure -lowering medicines (J).Chronobiol Int,2013,30(1-2):340. (11) HERMIDA RC,AYALA DE,MOJON A,et al.Role of time-of-day of hypertension treatment on the J-shaped relationship between blood pressure and cardiovascular risk (J).Chronobiol Int,2013,30(1-2):328. (12) SINGH R,SHARMA P K,MALVIYA R.Circadian cycle and chronotherapeutics:recent trend for the treatment of various biological disorders (J). Recent Pat Drug Deliv Formul,2012,6(1):80. (13) 中国血压测量工作组. 中国血压测量指南(J). 中华高血压杂志, 2011,19(12):1101. (14) NEUMANN S A,JENINGS J R,MULDOON M F,et al.White coat hypertension and autonomic nervous system dysregulation (J).Am J hypertens,2005,18(5 pt 1):584. (15) PARATI G, ESLER M.The human sympathetic nervous system:itsrelevance in hypertension and heart failure(J).Eur Heart J,2012,33(9):1058. (16) GRASSI G,SERAVALLE G, TREVANO F Q,et al.Neurogenic abnormali-ties in masked hypertension(J).Hypertension,2007,50(3):537. (17) 欧洲高血压学会/欧洲心脏病学会.欧洲高血压学会/欧洲心脏病学会:高血压管理指南(第四部分)(J).中国卒中杂志,2014,9(4):328. (18) WHITE W B, DEY H M, SCHULMAN P.Assessment of the daily blood pressure load as a determinant of cardiac function in patients with mild to moderate hypertension.Am Heart J,1989,118:782. (19) RAYMAN R B,HASTINGS J D,KRUYER W B,et al.Clinical aviationmedicin(M).Third ed.New York:Castle Connolly Graduate Medical Publishing,2001 :245. (20) 张俊琦,康晓曦,汤亚昕,等. 带药飞行对飞行员高血压病患者血压变异性的影响(J). 西南国防医药 2014,24(12):1356.
2016, Vol. 34 
