2065例急诊高血压病人发病特点分析  

Analysis of Characteristics of 2065 Emergency Patients with Hypertension

作　　者：张真[1] 朱家旺[1] 武强彬[1] 罗洋[1] 关鹏[1] 张晓磊[1] 高万朋[1] 徐强[1] ZHANG Zhen;ZHU Jiawang;WU Qiangbin;LUO Yang;GUAN Peng;ZHANG Xiaolei;GAO Wanpeng;XU Qiang(Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China)

机构地区：[1]天津中医药大学第二附属医院,天津300250

出　　处：《中西医结合心脑血管病杂志》2021年第16期2716-2721,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家重点研发计划(No.2018YFC1707404);第六批全国老中医药专家学术经验继承工作项目。

摘　　要：目的分析2065例急诊高血压病人发病时间和用药情况,并探讨急诊高血压就诊人数与主要气象因素的关系。方法收集2018年急诊就诊的2065例高血压病人,回顾性分析病人数量最多的月份和时间并描绘曲线,同时利用气象学资料分析气温、变温、主要污染颗粒物对病人数量影响。结果急诊高血压病人存在性别差异,女性病人多于男性;病人发病高峰期出现在3月和10月至11月,4月高血压危象病人比例最高;一日之中峰值出现在20:00。日最低温度是急诊高血压危象病人的影响因素(P<0.01);每日高血压就诊人数与日平均气温呈负相关(r=-0.246,P<0.01),与PM2.5(r=0.152,P<0.01)、NO_(2)(r=0.233,P<0.01)和SO_(2)(r=0.126,P<0.05)呈正相关;高血压危象就诊人数与日平均气温呈负相关(r=-0.235,P<0.01),与SO_(2)(r=0.124,P<0.05)及NO_(2)(r=0.213,P<0.01)呈正相关。多因素线性回归分析结果显示:日平均气温、SO_(2)和NO_(2)是每日高血压就诊人数与高血压危象就诊人数的影响因素;钙通道阻滞剂和血管紧张素转换酶抑制剂是紧急降压的首选药物。结论血压波动是一个复杂的调控过程,既受到气象因素影响,与心理因素有关,从中医“肝应春”理论出发,有助于全面认识血压波动的机制,预防高血压危象。Objective To analyze the time of onset and medication status of 2065 emergency patients with hypertension,and to explore the correlation between the number of emergency patients with hypertension and the main meteorological factors.Methods A total of 2065 patients with hypertension who visited the emergency department in 2018 were collected.The month and time with the peak number of patients were analyzed retrospectively and the curves were drawn.The effects of temperature,temperature change and major pollution particles on the number of patients were analyzed.Results Gender differences related to emergency hypertensive patients,female patients were more than males.Peak period of patients occurred in March and From October to November,the proportion of hypertensive crisis patients was the highest in April,and the peak of a day appeared at 20:00.The numbers of daily hypertension visits were negatively correlated with the daily mean temperature(r=-0.246,P<0.01),and were positively correlated with PM2.5(r=0.152,P<0.01),NO_(2)(r=0.233,P<0.01),and SO_(2)(r=0.126,P<0.05).The numbers of daily hypertensive crisis patients were negatively correlated with the daily mean temperature(r=-0.235,P<0.01),and were positively correlated with SO_(2)(r=0.124,P<0.05)and NO_(2)(r=0.213,P<0.01).The multivariate linear regression analysis showed that mean temperature,SO_(2) and NO_(2) were the influencing factors for the number of patients with hypertension and hypertensive crisis.Calcium channel blockers(CCB)and angiotensin-converting enzyme inhibitors(ACEI)were the drugs of first choice for reducing emergency blood pressure.Conclusion Blood pressure fluctuation was a complex regulation process,which was influenced by meteorological factors and related to psychological factors.Based on traditional Chinese medicine theory of"liver should be in spring",it was helpful to fully understand the mechanism of blood pressure fluctuation and prevent hypertensive crisis.

关 键 词：高血压 急诊病人 高血压危象 发病情况 

分 类 号：R54[医药卫生—心血管疾病]