卧立位血压测量时机与频次对体位性低血压检出率的影响  

The influence of the time and frequency of orthostatic blood pressure measurements on the detection rate of orthostatic hypotension

作　　者：沈丹彤[1] 李志樑[1] 潘春梅[2] 罗勇 林仲秋[2] 黄怀[4] 

机构地区：[1]南方医科大学附属珠江医院心血管内科 [2]广州军区广州总医院干部病房四科 [3]广东省珠海市75645部队卫生所 [4]广州军区广州总医院神经康复二科

出　　处：《中华高血压杂志》2014年第6期571-575,共5页Chinese Journal of Hypertension

基　　金：广东省科技计划项目(2010B031500015)

摘　　要：目的明确不同卧立位血压测量时机与频次对体位性低血压(OH)检出率的影响。方法入选2012年3月至2013年1月广州军区广州总医院就诊或住院的有OH相关症状者193名和75645部队卫生所无OH相关症状者574名,根据OH诊断标准分为非OH组(n=683)和OH组(n=84),测量基线身高、体质量、腰围、臀围、卧位心率;在第1、8天上下午共进行4次血压测量(包括卧位和立位1、3min),分析OH检出率和卧立位血压变化规律。结果与非OH组比较,OH组年龄,帕金森病、服用降压药物、女性所占比例较高,而腰围、臀围较低。Bland-Alman分析结果显示,不同测量时机的卧立位血压变化值一致性差。但与上下午的测量值比较,两个测量日的卧立位血压变化值一致性较好。两个测量日的OH检出率差异无统计学意义(69.1%比53.6%,P>0.05),而上午OH检出率高于下午(75.0%比38.1%,P<0.01)。结论通过反复卧立位血压测量可提高OH检出率,建议选择在上午进行卧立位血压测量。Objective To examine the influence of the opportunity and frequency of orthostatic blood pressure measurements on the detection rate of orthostatic hypotension （OH）. Methods From March 2012 to January 2013, a total of 767 subjects were recruited, including 193 clinic or hospitalized patients with OH related symptoms from the General Hospital of Guangzhou Military Command of People＇s Liberation Army（PLA） and 574 subjects without OH related symptoms from the Health Department of 75645 Unit of PLA. According to the OH diagnosis criteria, all subjects were classified into the non-OH group （n= 683） and the OH group （n= 84）. Data on body height and weight, waist and hip circumstances, resting heart rate were recorded at baseline. At both the morning and afternoon of 1st and 8th days, systolic and diastolic blood pressures were respectively measured at both recumbent and orthostatic positions, and then orthostatic changes in systolic and diastolic blood pressures were calculated. The detection rate of OH and the orthostatic changes of blood pressures were analyzed. Results Subjects in OH group were older than those in non-OH group, and the percentages of Parkinsoffs disease, patients under antihypertensive treatment, and female gender were higher, but waist and hip circumstances were lower in OH group. As indicated by the Bland-Alman method, the consistency in the orthostatic changes of blood pressures was poor between the morning and afternoon measurements, whereas this consistency was better between the 1st and 8th days at the same measurement time. There was no statistical difference in the detection rate of OH between the 1st （69.1%） and 8th （53.6 %, P〉0.05） days. In contrast, the detection rate was higher in the morning （75.0%） than in the afternoon （38.1%, P〈0.01 ）. Conclusion Repeated measurements of orthostatic blood pressures can improve the detection rate of OH, and it is recommended to perform the measurements in the morning.

关 键 词：体位性低血压 检出率 诊断 

分 类 号：R544.2[医药卫生—心血管疾病]