H型高血压患者伴发体位性血压异常及靶器官损害情况检测分析  

Analysis of abnormal orthostatic blood pressure and targeted organ damages in patients with type H hypertension

作　　者：卫建辉 翟哲民[1] 李敏 尚丽丽[1] 刘存学 刘玲 张翠萍 齐鹤 王琦 张翠 WEI Jianhui;ZHAI Zhemin;LI Min;SHANG Lili;LIU Chunxue;LIU Ling;ZHANG Cuiping;QI He;WANG Qi;ZHANG Cui(Department of Hypertension,Sanmenxia Central Hospital,Sanmenxia 47200,Henan Province,China)

机构地区：[1]三门峡市中心医院高血压科,河南省三门峡市472000

出　　处：《内科》2021年第6期734-737,749,共5页Internal Medicine

基　　金：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H型高血压患者伴发体位性低血压(OH)和体位性高血压(OHT)的情况、血压水平以及靶器官损害的情况。方法选取2019年1月至2020年6月在我院住院治疗的H型高血压患者300例为观察对象,对其伴发OH和OHT的情况、血压水平以及靶器官的损害情况进行检测分析。结果300例H型高血压患者中,OH患者102例,占34.0%;OHT患者38例,占12.7%;ONT患者(体位性正常血压,无上述OHT和OH)160例,占53.3%。OH、OHT、ONT组患者的性别、年龄、BMI、CRP、Hcy、UA、空腹血糖、NT-proBNP、血肌酐以及MAU水平比较,差异均无统计学意义(P>0.05)。OH、OHT、ONT组患者的全天血压、白天血压及夜间血压值比较,差异均有统计学意义(P<0.05),均表现为OHT组>OH组>ONT组。OH、OHT、ONT组患者的脑卒中、左室高电压、eGFR下降、视网膜动脉病变发生率比较,差异均有统计学意义(P<0.05),均表现为OHT组>OH组>ONT组。结论H型高血压患者伴发OHT或OH的比例较高,伴发OHT或OH患者的靶器官损害严重,积极控制血压水平或可有效减少或延缓患者急性心脑血管事件的发生。Objective To explore the situation of orthostatic hypotension(OH)and orthostatic hypertension(OHT),blood pressure levels,and targeted organ damages in patients with type H hypertension.Methods A total of 300 patients with type H hypertension who were hospitalized in our hospital from January 2019 to June 2020 were selected as the observation objects,and the concomitant conditions of OH and OHT,blood pressure levels,and targeted organ damage of these patients were detected and analyzed.Results Among the 300 patients with type H hypertension,102 were OH patients,accounting for 34.0%,whereas 38 were OHT patients,accounting for 12.7%,and 160 were ONT patients(normal orthostatic blood pressure,without the above-mentioned OHT and OH),accounting for 53.3%.There were no statistically significant differences in gender,age,BMI,CRP,Hcy,UA,fasting blood glucose,NT-proBNP,serum creatinine and MAU levels among the OH group,OHT group,and ONT group(P>0.05).The whole day blood pressure,daytime blood pressure,and nocturnal blood pressure in the three groups presented in a descending order as follows:the OHT group,the OH group,and the ONT group,with statistically significant differences(P<0.05).The incidence of stroke,left ventricular high voltage,eGFR decrease,and retinal artery disease presented in a descending order as below:the OHT group,the OH group,and the ONT group,with statistically significant differences(P<0.05).Conclusion The proportion of type H hypertension patients with OHT or OH is high,and the targeted organs of patients with OHT or OH are severely damaged.Active control of blood pressure level may effectively reduce or delay the occurrence of acute cardiovascular and cerebrovascular events in these patients.

关 键 词：H型高血压 体位性低血压 体位性高血压 靶器官损害 

分 类 号：R544.1[医药卫生—心血管疾病]