直立性低血压的年龄和性别差异  

Differences in age and gender in orthostatic hypotension

作　　者：袁鹤立[1] 王成[1] 吴礼嘉[1] 林萍[1] 崔晓丽[1] 李芳[1] 祝立平[1] 康美华[1] 

机构地区：[1]中南大学湘雅二医院儿科心血管病研究室中南大学儿科学研究所,长沙410011

出　　处：《中华临床医师杂志（电子版）》2011年第17期4945-4948,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：湖南省科技厅资助项目(2008SK3111);中南大学研究生学位论文创新基金项目(2010ssxt291)

摘　　要：目的探讨直立性低血压(OH)的年龄和性别差异。方法 2001年1月至2010年4月在中南大学湘雅二医院晕厥专科门诊就诊或住院的不明原因晕厥或头晕患者1681例进行直立倾斜试验(HUTT)检查中符合OH诊断的患者73例,分为成人组(≥18岁)和儿童组(<18岁),分析其病程、诊断率、HUTT时3min血压变化的年龄和性别差异。结果 (1)病程及发病年龄:OH病程在成人组为0.23～552个月,平均(31.08±22.72)个月,儿童组为0.3～72个月,平均(12.69±18.32)个月,两组均表现为男性与女性比较无统计学差异[分别为(31.08±22.72)个月vs.(116.22±158.24)个月,t=2.049,P>0.05;(10.38±14.59)个月vs.(15.0±21.53)个月,t=0.814,P>0.05]。发病年龄在成人组为20～70岁,平均(45.96±14.81)岁,女性小于男性(t=6.828,P<0.05);儿童组为6～17岁,平均(10.47±2.40)岁,未见性别差异(t=1.411,P>0.05)。(2)诊断率及HUTT时3min内血压变化:OH诊断率在成年组(5.47%,28/512)和儿童组(3.85%,45/1169)之间差异无统计学意义(χ2=3.13,P>0.05)。73例OH患者性别比率女:男为1.14:1,但女性比例在成人组(64.28%,18/28)与儿童组(46.67%,21/45)差异未见统计学意义(χ2=2.16,P>0.05)。HUTT时3min内收缩压及舒张压下降量在年龄及性别间差异亦未见统计学意义(P>0.05)。结论 OH病程及血压下降量不存在年龄和性别差异,成年患者发病年龄女性小于男性,诊断率无年龄差异,这对临床上诊治OH具有指导意义。Objective To study differences in age and gender in orthostatic hypotension(OH).Methods 73 patients of OH were diagnosed from 1681(male 778 and female 903)ones with syncope and dizziness by head-up tilt table test(HUTT).They were 3.1 to 73 years old[(19.5 ±14.65)years old].The patients were divided into adults group(≥18 years old)and children group(<18 years old)according to the age.The course of disease,diagnostic rate,changes of blood pressure in OH and their relationship with age and gender were analysed.Results(1)The course and onset age of OH:the course was 0.23-552(31.08±22.72)months in adults,there was no difference between male and female[(31.08±22.72)months vs.(116.22±158.24)months,t=2.049,P>0.05)].In children group,the course was 0.3-72(12.69±18.32)months and there was no difference between boys and girls [(10.38±14.59)months vs.(15.0±21.53)months,t=0.814,P>0.05].The adults'onset age in OH was 20 to 70 years old[(45.96±14.81)years old],and female was younger than male(t=2.049,P<0.05).It was 6-17 years old[(10.47±2.40)years old]in children group without significant difference in gender(t=1.411,P>0.05).(2)The diagnostic rate and changes of blood pressure of OH:the diagnostic rate of OH was not different in age and gender(χ2=3.13 and 2.16,P>0.05).There was no difference in systolic blood pressure and diastolic blood pressure decrease within 3 minutes during HUTT in age groups and gender ones(P>0.05).Conclusions There are no differences of age and gender in the course and systolic blood pressure and diastolic blood pressure decrease within 3 minutes during HUTT of OH.There are also no difference of age and gender in the diagnostic rate.The adult female's onset age is smaller than male's,that is of instructive significance in the diagnosis and treatment of OH in clinic.

关 键 词：低血压 直立性 发病年龄 性别比率 倾斜试验 

分 类 号：R544.2[医药卫生—心血管疾病]