难治性高血压患者体位性低血压和体位性高血压与靶器官损害的关系研究  

Association of orthostatic hypotension and orthostatic hypertension with target organ damage in patients with refractory hypertension

作　　者：卫建辉 翟哲民[1] 王玉梅 李敏 杜柳杨 乔纤 烟海丽 WEI Jianhui;ZHAI Zhemin;WANG Yumei;LI Min;DU Liuyang;QIAO Qian;YAN Haili(Department of Hypertension,Sanmenxia Central Hospital,Henan Province,Sanmenxia,Henan,472000,China;Sanmenxia Vocational and Technical College,Sanmenxia,Henan,472000,China)

机构地区：[1]河南省三门峡市中心医院高血压科,河南三门峡472000 [2]三门峡职业技术学院,河南三门峡472000

出　　处：《现代医药卫生》2021年第13期2174-2178,2182,共6页Journal of Modern Medicine & Health

基　　金：河南省三门峡市应用技术研究与开发计划科技攻关项目(2017010315)。

摘　　要：目的探讨难治性高血压(RH)患者伴体位性低血压(OH)和体位性高血压(OHT)与靶器官损害的关系。方法选取2018年1月至2020年6月河南省三门峡市中心医院收治的住院RH患者190例,对其进行卧、立位血压测量,依据体位血压情况分为OH组(55例)、OHT组(37例)、体位性正常血压(ONT)组(98例),分析各组患者构成比、血压特点等,同时评估其靶器官功能。结果在190例患者中OH 55例,构成比为28.95%,OHT 37例,构成比为19.47%,ONT 98例,构成比为51.58%;3组患者全天平均血压、白天平均血压、夜间平均血压,靶器官损害发生率比较,差异均有统计学意义(P<0.05);与ONT组比较,OHT组患者心脏、肾脏、视网膜动脉损伤风险分别为ONT组的10.415、4.308、11.040倍,差异均有统计学意义[95%可信区间:1.351~80.291、1.221~15.196、1.434~85.004,P<0.05);OH组患者发生脑损伤的风险为ONT组的2.727倍,差异接近于统计学意义(95%可信区间:0.966~7.702,P=0.0582)。结论与RH患者伴ONT比较,RH患者伴OHT发生心脏、肾脏、视网膜动脉损害的风险明显升高。Objective To investigate the association of orthostatic hypertension(OHT)and orthostatic hypotension(OH)with hypertensive target organ damage in patients with refractory hypertension(RH).Methods A total of 190 RH patients admitted to our hospital from January 2018 to June 2020 were selected to have their blood pressure measured in decubitus position.According to their postural blood pressure,they were divided into OH group,OHT group and postural normal blood pressure(ONT)group.The composition ratio and blood pressure characteristics of each group were analyzed,and the target organ function was also evaluated.Results Among the 190 RH patients,55 patients in the OH group had a composition ratio of 28.95%,37 patients in the OHT group had a composition ratio of 19.47%,and 98 patients in the ONT group had a composition ratio of 51.58%.There were statistically significant differences in the incidence of target organ damage among the three groups(P<0.05);Compared with ONT group,the risk of heart,kidney and retinal artery injury in OHT group was 10.415 times(95%CI:1.351-80.291),4.308 times(95%CI:1.221-15.196)and 11.040 times(95%CI:1.434-85.004),respectively,the differences were statistically significant(P<0.05),the risk of brain injury in OH group was 2.727 times higher than that in ONT group(95%CI:0.966-7.702,P=0.0582),which was close to statistical significance.Conclusion Compared with ONT in RH patients,the risk of heart,kidney and retinal artery damage in RH patients with OHT is significantly higher.

关 键 词：难治性高血压 体位性低血压 体位性高血压 靶器官 

分 类 号：R544.11[医药卫生—心血管疾病]