老年高血压患者体位性血压改变的相关危险因素及靶器官损害研究  

Study on the risk factors in elderly hypertension patients with orthostatic blood pressure changes and target organ damage

作　　者：张利 张洪柱 余苏姣 陈红玉 

机构地区：[1]杭州市老年病医院慢性创面诊治中心,浙江杭州310022

出　　处：《中国医药导报》2014年第32期34-37,共4页China Medical Herald

基　　金：浙江省杭州市卫生科技计划项目(编号2013B22)

摘　　要：目的：了解老年高血压人群中体位性低血压和体位性高血压的发生情况，探讨相关危险因素与靶器官的损害情况。方法选取2012年8月-2014年1月在杭州市老年病医院住院的老年高血压患者190例，对患者的卧位和立位血压进行测量，根据血压测量结果，将190例患者分为体位性低血压（OH）组（32例）、体位性血压正常（ONT）组（134例）和体位性高血压（OHT）组（24例），对各组的临床基本资料、血液生化指标、颈动脉超声、心脏彩超、头颅MRI等临床检查结果进行统计分析。结果≥80岁老年患者的OH和OHT的发生率分别为26.67%（16例）和23.33%（14例），明显高于60-〈80岁老年患者[12.31%（16例），7.69%（10例）]，差异有统计学意义（P〈0.05）。OH组、ONT组和OHT组在使用4类常用降压药（钙离子拮抗剂、血管紧张素转化酶受体拮抗剂、血管紧张素转化酶抑制剂、利尿剂）方面差异无统计学意义（P〉0.05）；三组头颅MRI结果、颈动脉超声结果、心脏彩超结果差异无统计学意义（P〉0.05）。结论 OH、OHT在老年人群尤其是80岁以上老年高血压人群中比较常见；OH、OHT的发生与临床上常用的4类降压药物的使用情况可能无关；OH、OHT的发生与患者脑部、颈动脉、心脏功能的异常发生情况可能无关。Objective To understand the occurrence of orthostatic hypotension and postural hypertension in elderly pa-tients with hypertension, discuss the risk factors and target organ damage. Methods 190 elderly patients with hyperten-sion in Geriatrics Hospital of Hangzhou City from August 2012 to January 2014 were selected. Supine and orthostatic blood pressure of patients were measured, according to the measurement results, 190 patients were divided into ortho-static hypotension （OH） group （32 cases）, orthostatic blood pressure normal （ONT） group （134 cases） and orthostatic hy-pertension （OHT） group （24 cases）, the basic clinical data, blood biochemical index, carotid ultrasonography, echocar-diography, cranial MRI, clinical examination results were analyzed. Results The incidence of OH and OHT in ≥80 years elderly patients [26.67% （16 cases）, 23.33% （14 cases）] were significantly higher than those in 60-〈80 years el-derly patients [12.31% （16 cases）, 7.69%（10 cases）], the differences were statistically significant （P〈 0.05）. 4 kinds of antihypertensive drugs using （calcium antagonist, ARB, ACEI, diuretics） of OH group, ONT group and OHT group were compared, the differences were not statistically significant （P〉0.05）. The results of cranial magnetic scanning, carotid artery ultrasound and echocardiography in three groups were compared, the differences were not statistically significant （P〉0.05）. Conclusion OH and OHT are more common in the elderly, especially in patients with hypertensive over 80 years old. The occurrence of OH and OHT has nothing to do with the using of clinical commonly used 4 kinds of anti-hypertensive drugs, and exception occurs of the brain, carotid artery and the cardiac function.

关 键 词：老年人 体位性高血压 体位性低血压 

分 类 号：R544.1[医药卫生—心血管疾病]