Abstract: Background　Blood pressure monitoring is a method that helps hypertensive patients to know their blood pressure level and control effects，and also an important way for early identification of hypertension-associated abnormalities.Community-based blood pressure measurement methods include office and follow-up blood pressure measurements and 24-hour ambulatory blood pressure monitoring（ABPM）.Objective　To compare the consistencies and differences of 24-hour ABPM，office and follow-up blood pressure measurements for hypertensive patients，offering a reference for the promotion of 24-hour ABPM.Methods　This study was carried out in a convenience sample of 169 cases of hypertension who received the management（including 24-hour ABPM） of Jinshan Industrial Area Community Health Center，Shanghai，from March 2017 to May 2018.By reviewing the electronic medical records，the results of 24-hour ABPM（daytime，night-time and average 24-hour blood pressure），and those of office and follow-up blood pressure measurements were collected.Consistencies and differences of these three measurements were compared.Results　Significant differences were observed when comparing daytime，night-time and average 24-hour blood pressure，office blood pressure and follow-up blood pressure by difference analysis（P<0.05）.Daytime，night-time，average 24-hour blood pressure，and follow-up blood pressure had poor consistency in the measurement of blood pressure with office blood pressure by consistency analysis（Kappa<0.400）.Conclusion　Combination of 24-hour ABPM，office and follow-up blood pressure measurements can improve the accuracy of community-based blood pressure monitoring for hypertensive patients.Attention should be paid to guide the patients using the appropriate monitoring way and inform them the matters that should be noted during the monitoring.

Key words: Hypertension, Blood pressure determination, 24-hour ambulatory blood pressure, Office blood pressure, Follow-up blood pressure, Difference, Consistency

摘要： 背景　血压监测能够帮助高血压患者了解自身血压情况和控制效果，同时也是早期识别高血压异常的一个重要环节。目前社区血压监测方式包括诊室血压、随访血压和24 h动态血压。目的　比较高血压患者24 h动态血压、诊室血压、随访血压的差异及诊断结果的一致性，为推广应用24 h动态血压监测提供经验借鉴。方法　采用方便抽样法，回顾性分析2017年3月—2018年5月上海市金山工业区社区卫生服务中心在管的、接受24 h动态血压监测的169例高血压患者的病历资料。通过电子病历获得其24 h动态血压（昼间血压、夜间血压、24 h平均血压）、诊室血压、随访血压，比较其差异及一致性。结果　差异性分析结果显示，昼间血压、夜间血压、24 h平均血压、诊室血压、随访血压比较，差异有统计学意义（P<0.05）。一致性检验结果显示，昼间血压、夜间血压、24 h平均血压、随访血压与诊室血压的一致性均较差（Kappa值<0.400）。结论　要精准监测社区高血压患者的血压情况，需要诊室血压、随访血压与24 h动态血压相结合，并注意指导患者进行动态血压监测时正确的监测方法及注意事项。

关键词: 高血压, 血压测定, 24 h动态血压, 诊室血压, 随访血压, 差异, 一致性