中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2014年
32期
34-37
,共4页
张利%张洪柱%余苏姣%陈红玉
張利%張洪柱%餘囌姣%陳紅玉
장리%장홍주%여소교%진홍옥
老年人%体位性高血压%体位性低血压
老年人%體位性高血壓%體位性低血壓
노년인%체위성고혈압%체위성저혈압
Elderly people%Orthostatic hypertension%Orthostatic hypotension
目的：了解老年高血压人群中体位性低血压和体位性高血压的发生情况，探讨相关危险因素与靶器官的损害情况。方法选取2012年8月~2014年1月在杭州市老年病医院住院的老年高血压患者190例，对患者的卧位和立位血压进行测量，根据血压测量结果，将190例患者分为体位性低血压(OH)组(32例)、体位性血压正常(ONT)组(134例)和体位性高血压(OHT)组(24例)，对各组的临床基本资料、血液生化指标、颈动脉超声、心脏彩超、头颅MRI等临床检查结果进行统计分析。结果≥80岁老年患者的OH和OHT的发生率分别为26.67%(16例)和23.33%(14例)，明显高于60~<80岁老年患者[12.31%(16例)，7.69%(10例)]，差异有统计学意义(P<0.05)。OH组、ONT组和OHT组在使用4类常用降压药(钙离子拮抗剂、血管紧张素转化酶受体拮抗剂、血管紧张素转化酶抑制剂、利尿剂)方面差异无统计学意义(P>0.05)；三组头颅MRI结果、颈动脉超声结果、心脏彩超结果差异无统计学意义(P>0.05)。结论 OH、OHT在老年人群尤其是80岁以上老年高血压人群中比较常见；OH、OHT的发生与临床上常用的4类降压药物的使用情况可能无关；OH、OHT的发生与患者脑部、颈动脉、心脏功能的异常发生情况可能无关。
目的：瞭解老年高血壓人群中體位性低血壓和體位性高血壓的髮生情況，探討相關危險因素與靶器官的損害情況。方法選取2012年8月~2014年1月在杭州市老年病醫院住院的老年高血壓患者190例，對患者的臥位和立位血壓進行測量，根據血壓測量結果，將190例患者分為體位性低血壓(OH)組(32例)、體位性血壓正常(ONT)組(134例)和體位性高血壓(OHT)組(24例)，對各組的臨床基本資料、血液生化指標、頸動脈超聲、心髒綵超、頭顱MRI等臨床檢查結果進行統計分析。結果≥80歲老年患者的OH和OHT的髮生率分彆為26.67%(16例)和23.33%(14例)，明顯高于60~<80歲老年患者[12.31%(16例)，7.69%(10例)]，差異有統計學意義(P<0.05)。OH組、ONT組和OHT組在使用4類常用降壓藥(鈣離子拮抗劑、血管緊張素轉化酶受體拮抗劑、血管緊張素轉化酶抑製劑、利尿劑)方麵差異無統計學意義(P>0.05)；三組頭顱MRI結果、頸動脈超聲結果、心髒綵超結果差異無統計學意義(P>0.05)。結論 OH、OHT在老年人群尤其是80歲以上老年高血壓人群中比較常見；OH、OHT的髮生與臨床上常用的4類降壓藥物的使用情況可能無關；OH、OHT的髮生與患者腦部、頸動脈、心髒功能的異常髮生情況可能無關。
목적：료해노년고혈압인군중체위성저혈압화체위성고혈압적발생정황，탐토상관위험인소여파기관적손해정황。방법선취2012년8월~2014년1월재항주시노년병의원주원적노년고혈압환자190례，대환자적와위화립위혈압진행측량，근거혈압측량결과，장190례환자분위체위성저혈압(OH)조(32례)、체위성혈압정상(ONT)조(134례)화체위성고혈압(OHT)조(24례)，대각조적림상기본자료、혈액생화지표、경동맥초성、심장채초、두로MRI등림상검사결과진행통계분석。결과≥80세노년환자적OH화OHT적발생솔분별위26.67%(16례)화23.33%(14례)，명현고우60~<80세노년환자[12.31%(16례)，7.69%(10례)]，차이유통계학의의(P<0.05)。OH조、ONT조화OHT조재사용4류상용강압약(개리자길항제、혈관긴장소전화매수체길항제、혈관긴장소전화매억제제、이뇨제)방면차이무통계학의의(P>0.05)；삼조두로MRI결과、경동맥초성결과、심장채초결과차이무통계학의의(P>0.05)。결론 OH、OHT재노년인군우기시80세이상노년고혈압인군중비교상견；OH、OHT적발생여림상상상용적4류강압약물적사용정황가능무관；OH、OHT적발생여환자뇌부、경동맥、심장공능적이상발생정황가능무관。
Objective To understand the occurrence of orthostatic hypotension and postural hypertension in elderly pa-tients with hypertension, discuss the risk factors and target organ damage. Methods 190 elderly patients with hyperten-sion in Geriatrics Hospital of Hangzhou City from August 2012 to January 2014 were selected. Supine and orthostatic blood pressure of patients were measured, according to the measurement results, 190 patients were divided into ortho-static hypotension (OH) group (32 cases), orthostatic blood pressure normal (ONT) group (134 cases) and orthostatic hy-pertension (OHT) group (24 cases), the basic clinical data, blood biochemical index, carotid ultrasonography, echocar-diography, cranial MRI, clinical examination results were analyzed. Results The incidence of OH and OHT in ≥80 years elderly patients [26.67% (16 cases), 23.33% (14 cases)] were significantly higher than those in 60-<80 years el-derly patients [12.31% (16 cases), 7.69%(10 cases)], the differences were statistically significant (P< 0.05). 4 kinds of antihypertensive drugs using (calcium antagonist, ARB, ACEI, diuretics) of OH group, ONT group and OHT group were compared, the differences were not statistically significant (P>0.05). The results of cranial magnetic scanning, carotid artery ultrasound and echocardiography in three groups were compared, the differences were not statistically significant (P>0.05). Conclusion OH and OHT are more common in the elderly, especially in patients with hypertensive over 80 years old. The occurrence of OH and OHT has nothing to do with the using of clinical commonly used 4 kinds of anti-hypertensive drugs, and exception occurs of the brain, carotid artery and the cardiac function.
