老年高血压伴血管迷走性晕厥患者晕厥先兆发生状况及危险因素分析  

The Occurrence and Risk Factors of Presyncope in Elderly Patients with Hypertension and Vasovagal Syncope

作　　者：韩芳旗 许岭平 侯军龙 秦黎明 陈斌 HAN Fangqi;XU Lingping;HOU Junlong;QIN Liming;CHEN Bin(Cardiovascular Department I,Xianyang Central Hospital,Xianyang,Shaanxi 712000,China;Cardiovascular Department II,Xianyang Central Hospital,Xianyang,Shaanxi 712000,China)

机构地区：[1]陕西省咸阳市中心医院心血管内一科,陕西咸阳712000 [2]陕西省咸阳市中心医院心血管内二科,陕西咸阳712000

出　　处：《转化医学杂志》2024年第10期1555-1558,1563,共5页Translational Medicine Journal

基　　金：陕西省重点研发计划项目(2022SF-291)。

摘　　要：目的了解老年高血压伴血管迷走性晕厥(VVS)患者晕厥先兆发生状况,并分析危险因素。方法选取2021年1月至2023年12月陕西省咸阳市中心医院收治的105例老年高血压伴VVS患者作为研究对象,根据患者在晕厥前是否有晕厥先兆设立无先兆组和先兆组。收集所有研究对象的临床资料。分析老年高血压伴VVS患者晕厥先兆的发生状况及危险因素。结果105例老年高血压伴VVS患者中,晕厥前无晕厥先兆的病例有52例,占49.52%(52/105);晕厥前有晕厥先兆的病例有53例,占50.48%(53/105)。在有先兆的患者中,最常见的先兆类型依次为头晕、出汗、恶心和视线模糊。无先兆组和先兆组2组患者饮酒史、血压控制情况、脑血管病、高脂血症比较差异无统计学意义(P>0.05)。与无先兆组相比,先兆组患者年龄更大、女性更多、体质量指数(BMI)更低,吸烟史和既往有糖尿病患者比例更高(P<0.05)。多因素Logistic回归分析显示:女性(OR=1.288,95%CI:1.092~1.518)、糖尿病(OR=1.808,95%CI:1.179~2.711)是老年高血压伴VVS患者出现晕厥先兆的危险因素(P<0.05)。结论女性和糖尿病患者是老年高血压伴VVS患者中更易出现晕厥先兆的高危群体。Objective To investigate the occurrence of presyncope in elderly patients with hypertension and vasovagal syncope(VVS)and analyze the risk factors.Methods 105 elderly patients with hypertension and vasovagal syncope who were admitted to Xianyang central hospital from January 2021 to December 2023 were selected as the study objects.According to whether the patients had syncope aura before syncope,they were divided into two groups.Clinical data of all subjects were collected to analyze the occurrence and risk factors of syncope aura in elderly patients with hypertension and VVS.Results Among 105 elderly patients with hypertension and VVS,52 cases(49.52%)had no presyncope before syncope.There were 53 cases with presyncope before syncope(50.48%).In patients with aura,the most common types of aura were,in order,dizziness,sweating,nausea,and blurred vision.There was no significant difference in drinking history,blood pressure control,cerebrovascular disease,and hyperlipidemia between the two groups(P>0.05).Compared with the group without aura,patients in the aura group were older,more female,had a lower BMI,and had a higher percentage of smokers and preexisting diabetes(P<0.05).Female(OR=1.288,95%CI:1.092-1.518)and diabetes(OR=1.808,95%CI:1.179-2.711)were identified as risk factors for presyncope in elderly patients with hypertension and VVS(P<0.05).Conclusion Female and diabetic patients are high-risk groups for presyncope in elderly patients with hypertension and VVS.

关 键 词：高血压 晕厥 血管迷走神经性 晕厥先兆 老年人 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病] R745.13[医药卫生—内科学]