高龄老年人餐后低血压与胰岛素和神经降压素的相关性研究  

A study on the association of postprandial hypotension with insulin and neurotensin in very old adults

作　　者：胡晖[1] 王希[2] 王云云 王可婧 刘爽 乔薇[2] Hu Hui;Wang Xi;Wang Yunyun;Wang Kejing;Liu Shuang;Qiao Wei(The First Department of Surgical Center of Coronary Heart Disease,Beijing Anzhen Hospital,Beijing 100029,China;The First Department of Health Care,China Japan-Friendship Hospital,Beijing100029,China)

机构地区：[1]北京安贞医院冠心病外科中心一病区,北京100029 [2]中日友好医院保健部一部,北京100029

出　　处：《中华老年医学杂志》2022年第9期1047-1051,共5页Chinese Journal of Geriatrics

基　　金：中央保健科研课题(2020YB27),中央保健科研课题(W2013BJ26)。

摘　　要：目的探讨高龄老年餐后低血压(PPH)患者与胰岛素、神经降压素的相关性。方法回顾性研究,选取2015年9月至2021年10月在中日友好医院保健部一部住院的年龄≥80岁的PPH患者22例和非PPH患者21例。监测两组患者空腹和餐后30min、60min、90min和120min的血压、血糖、胰岛素、神经降压素水平,比较各指标在进餐前后的变化幅度,对餐后血压最大降幅与血糖最大增幅、胰岛素最大增幅、神经降压素最大增幅进行Pearson相关性分析。结果PPH组与非PPH组患者比较,餐后收缩压最大降幅增加,(35.5±13.2)mmHg(1mmHg=0.133kPa)比(16.0±8.6)mmHg(t=4.135,P<0.01);餐后胰岛素最大增幅增加,(20.9±4.2)mU/L比(12.1±4.1)mU/L(t=3.949,P<0.01),餐后血糖最大增幅为(3.6±1.8)mmol/L比(2.5±0.5)mmol/L(t=1.912,P>0.05),神经降压素最大升幅为65.70(22.0,110.1)ng/L比112.2(47.2,270.2)ng/L(Z=1.817,P>0.05)。餐后收缩压最大降幅与胰岛素最大增幅呈正相关(r=0.907,P<0.05),餐后收缩压最大降幅与血糖最大增幅无相关性(r=0.016,P>0.05),餐后收缩压最大降幅与神经降压素最大增幅亦无相关性(r=0.396,P>0.05)。结论老年人PPH与餐后胰岛素分泌异常增加有关。Objective To investigate the association of postprandial hypotension(PPH)with insulin and neurotensin(NT)in very old adults.MethodsIn this retrospective study,22 people with PPH and 21 without non-PPH,aged≥80,were enrolled from patients hospitalized at the First Division of the Health Department of China-Japan Friendship Hospital between September 2015 and October 2021.The levels of blood pressure,blood glucose,insulin and NT at fasting and 30,60,90 and 120 minutes after a meal were monitored.Changes in values of each parameter before and after a meal were compared between the two groups,and the correlation of the maximum decrease in postprandial blood pressure with the maximum increase in blood glucose,insulin and neurotensin was analyzed.ResultsThe maximum decrease in postprandial systolic blood pressure(SBP)in the PPH group was significantly higher than that in the non-PPH group[(35.5±13.2)mmHg(1 mmHg=0.133 kPa)us.(16.0±8.6)mmHg,t=4.135,P<0.01)].The maximum increase in postprandial insulin was significantly higher than that in the non-PPH group[(20.9±4.2)mU/L us.(12.1±4.1)mU/L,t=3.949,P<0.01)J.There was no statistically significant difference between the PPH and non-PPH groups in the maximum increase in postprandial blood glucose[(3.6±1.8)mmol/L us.(2.5±0.5)mmol/L,t=1.912,P>0.05]Jor NT[65.7(22.0,110.1)ng/L us.112.2(47.2,270.2)ng/L,Z=1.817,P>0.05)J.There was a significant positive correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in insulin(r=0.907,P<0.05).There was no correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in blood glucose(r=0.016,P>0.05).There was no correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in NT(r=0.396,P>0.05).ConclusionsThe PPH is related to abnormal increases in postprandial insulin secretion.

关 键 词：饭后期间 低血压 胰岛素 神经降压肽 

分 类 号：R544.2[医药卫生—心血管疾病]