多系统萎缩患者直立性低血压的临床特点及相关因素分析  

Analysis of Clinical Characteristics and Risk Factors of Orthostatic Hypotension in Patients with Multiple System Atrophy

作　　者：刘丽[1] 李丽霞[1] 张铁梅[1] 张巍[2] Liu Li;Li Lixia;Zhang Tiemei(Department of General Internal Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院综合内科,100070 [2]首都医科大学附属北京天坛医院神经病学中心认知障碍性疾病科,100070

出　　处：《医学研究杂志》2020年第2期140-143,共4页Journal of Medical Research

基　　金：国家重点研发计划重点专项基金资助项目(2016YFC1306300、2016YFC1306000);国家重点研发计划-欧盟地平线2020计划合作项目(2017YFE0118800-779238);国家自然科学基金资助项目(面上项目)(81571229、81071015、30770745);国家自然科学基金资助项目重点项目(81030062);北京市教育委员会科技发展计划重点项目(KZ201610025030);北京市自然科学基金资助重点项目(4161004、kz200910025001);北京市自然科学基金资助项目(面上项目)(7082032);国家重点基础研究发展计划项目(2011CB504100);国家科技重大专项基金资助项目(2011ZX09102-003-01);中国科学技术部国家关键技术研究与开发项目(2013BAI09B03);首都临床特色应用研究(Z12110700100000、Z121107001012161);北京市中医药科技发展基金资助项目(JJ2018-48);北京市卫生系统高层次卫生技术人才培养计划资助项目(2009-3-26);北京脑重大疾病研究院基金资助项目(BIBD-PXM2013_014226_07_000084);北京市属高等学校创新团队建设与教师职业发展计划项目(IDHT20140514);北京市优秀人才培养项目(20071D0300400076);北京市保健科研课题资助项目(京15-2);首都医科大学基础-临床科研合作基金资助项目(2015-JL-PT-X04、14JL5、10JL49);首都医科大学校自然科学基金资助项目(PYZ2018077);首都医科大学附属北京天坛医院青年科研基金资助项目(2015-YQN-14、2015-YQN-15、2015-YQN-17)。

摘　　要：目的研究多系统萎缩(MSA)患者直立性低血压(OH)的临床特点和危险因素。方法回顾性选择2014年1月~2019年1月在首都医科大学附属北京天坛医院住院的MSA患者327例,研究MSA伴OH患者的临床特点,分析MSA伴OH患者与不伴OH患者的性别组成、发病年龄、病程、MSA分型及一系列实验室指标差异有无统计学意义;并将MSA伴OH与上述因素进行Pearson相关性分析。结果在327例MSA患者中,195例(59.6%)存在OH,其中有头晕症状者103例,4例患者反复晕厥发作;卧立位收缩压差值≥50mmHg者16例,最大差值为88mmHg;立位收缩压≤80mmHg者15例,立位收缩压≤70mmHg者5例,最低立位血压为65/44mmHg。与MSA不伴OH组比较,MSA伴OH组TG水平更低(1.26±0.62mmol/L vs 1.54±0.87mmol/L,P<0.05)。相关性分析显示,MSA患者OH与TG水平(r=-0.184,P=0.001)显著相关。结论MSA患者普遍存在OH,TG水平减低是MSA患者伴发OH的独立危险因素。Objective To study the clinical characteristics and risk factors of orthostatic hypotension(OH)in patients with multiple system atrophy(MSA).Methods A retrospective study was conducted on 327 patients with MSA hospitalized in Beijing Tiantan Hospital from January 2014 to January 2019,and patients were divided into MSA with OH group and MSA without OH group.The clinical characteristics of MSA patients with OH were studied.The gender,duration of disease,age of onset,types of MSA and a body of laboratory index of MSA with OH and MSA without OH were analyzed.The correlation between MSA with OH and the above factors was analyzed.Results(1)Among 327 patients with MSA,195 cases(59.6%)had OH,103 had dizziness,4 had recurrent syncope attacks,16 patients supination orthostatism blood difference≥50mmHg and the maximum difference was 88mmHg,15 patients orthostatic systolic pressure≤80mmHg,5 had orthostatic systolic pressure(≤70mmHg)and the lowest orthostatic blood pressure was 65/44mmHg.(2)TG level of MSA with OH patients was significantly lower(1.26±0.62mmol/L vs 1.54±0.87mmol/L,P<0.05)than MSA without OH patients.(3)The correlation analysis showed that OH was associated with TG level(r=-0.184,P=0.001).Conclusions OH is very common in MSA patients.Decreased TG level is the independent risk factors for OH in MSA patients.

关 键 词：多系统萎缩 直立性低血压 甘油三酯 自主神经功能障碍 

分 类 号：R544[医药卫生—心血管疾病]