高龄老年人体位性低血压与心左室结构和功能的相关性研究  

Correlation between orthostatic hypotension and left ventricular structure and function in elderly patients

作　　者：吕晶[1] 陈绍稀 柴栖晨[1] 陈旭娇[1] 

机构地区：[1]浙江医院老年综合示范病房,浙江杭州310013 [2]浙江中医药大学,浙江杭州310053

出　　处：《中国病理生理杂志》2013年第11期2100-2102,共3页Chinese Journal of Pathophysiology

摘　　要：目的:研究高龄老年人群体位性低血压(orthostatic hypotension,OH)的发生率以及OH与左心室结构及功能的关系。方法:对我科≥80岁的126例高龄老年住院患者进行立卧位血压测定,统计高龄老年人群中OH的发生率;并将患者分为OH组(n=45)与非OH(n=81)组,对2组患者行心脏超声检查,检测和计算左室的结构和功能指标,分析OH与心脏结构及功能的相关性。结果:高龄老年人群总的OH发生率为35.7%。与非OH组比较,OH组左心室质量指数、舒张末期左心室内径和收缩末期左心室内径均明显偏高,2组比较差异有统计学意义(P<0.05);OH组左心室射血分数和左心室短轴缩短率显著低于非OH组,2组比较差异有统计学意义(P<0.01)。相关分析显示OH与左室结构指标呈正相关(P<0.05),与左室功能指标呈负相关(P<0.01)。结论:OH患者在高龄老年人群中比例较高。OH与左心室结构和功能密切相关,与非OH患者相比,OH患者左室结构和功能受损更严重。AIM： To study the prevalence rate of orthostatic hypotension （OH） in elderly patients and to investigate the correlation between OH and left ventricular structure and function. METHODS： This study was conducted in 126 hospitalized patients aged I〉80 years in our department. The orthostatic blood pressure was measured in the supine position after resting for over 5 min and at 0 and 2 min after standing. The patients were divided into non-OH group （ the patients without OH, n = 81 ） and OH group （the patients with OH, n = 45 ）. Cardiac ultrasonography was conducted in all patients, and the parameters of the left ventricular structure and function were measured and calculated. The correlation between OH and left ventricular structure and function was also analyzed. RESULTS： The prevalence of OH was 35.7% in elderly patients. The significant differences between non-OH group and OH group for left ventricular mass index （P 〈 0.05 ）, left ventricular end-diastolic diameter（ P 〈 0.05 ）, left ventricular end-systolic diameter （ P 〈 0.05 ）, ejection fraction （P 〈 0.01 ） and fractional shortening （P 〈 0.01 ） were observed. Correlation analysis revealed that OH was positively correlated with the parameters of left ventricular structure, and was negatively correlated with the parameters of left ventricular function. CONCLUSION： Elderly patients are at high risk of OH. OH patients have worse left ventricular structure and function as compared with non-OH patients.

关 键 词：高龄老年人 体位性低血压 左心室质量指数 左心室射血分数 左心室短轴缩短率 

分 类 号：R544.2[医药卫生—心血管疾病]