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目的:了解中青年人群原发性高血压病患者早期干预治疗的预后。方法:选择动态血压增高而临床未确诊为高血压病(即临界高血压病)的中青年患者300例(观察组),另选280例动态血压正常者作对照(对照组)。将观察组分为药物治疗组、非治疗组、改变生活方式组三小组,分别给以不同的处理;三组患者均随访5年。结果:①观察组动态血压参数较对照组明显增高(P<0.05～<0.001)。②治疗后观察组三小组动态血压各参数比较,差异有显著性(P<0.01)。③随访结果:药物治疗组未见发展为明显的高血压病者和心脑血管事件者。非治疗组64例(68.1%)发展为明显的高血压,其中6例(6.4%)发生脑梗塞,2例(2.1%)发生脑出血,10例(10.6%)发生左心室肥厚。结论:动态血压监测在早期诊断高血压方面,有着明显的优势。早期高血压属于可逆性阶段,经积极治疗可以痊愈。
OBJECTIVE: To understand the prognosis of early intervention in middle-aged and young patients with essential hypertension. Methods: 300 young and middle-aged patients (observation group) with elevated blood pressure but not clinically diagnosed as hypertensive disease (ie, critical hypertensive disease) were enrolled. Another 280 patients with ambulatory blood pressure were selected as control group (control group). The observation group was divided into three groups: drug treatment group, non-treatment group and lifestyle change group, which were given different treatments respectively; all three groups were followed up for 5 years. Results: ① The ambulatory blood pressure parameters in the observation group were significantly higher than those in the control group (P <0.05 ~ <0.001). ② After treatment, there were significant differences between the three groups in the parameters of ambulatory blood pressure (P <0.01). ③ follow-up results: no significant development of drug treatment in patients with hypertension and cardiovascular events. Sixty-four (68.1%) patients in the untreated group developed significant hypertension, 6 of whom (6.4%) developed cerebral infarction, 2 (2.1%) developed cerebral hemorrhage and 10 (10.6%) developed left ventricular hypertrophy. Conclusion: Ambulatory blood pressure monitoring has obvious advantages in the early diagnosis of hypertension. Early high blood pressure is reversible stage, after active treatment can be cured.