中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
9期
929-933
,共5页
辛伟%李小鹰%林智勤%王岩
辛偉%李小鷹%林智勤%王巖
신위%리소응%림지근%왕암
低血压,直立性%高血压%颈动脉血栓形成%压力感受器反射%横断面研究
低血壓,直立性%高血壓%頸動脈血栓形成%壓力感受器反射%橫斷麵研究
저혈압,직립성%고혈압%경동맥혈전형성%압력감수기반사%횡단면연구
Hypotension,orthostatic%Hypertension%Carotid artery thrombsis%Baroreflex%Cross-sectional study
目的 观察老年社区人群颈动脉粥样硬化斑块形成与体位性血压变异的相关性. 方法 采用横断面研究设计,通过现场标准问卷、体格检查、静脉血生化检查获得受试者基本临床资料,并行颈动脉超声检查明确其是否存在颈动脉斑块及分布情况.分别测定受试者卧、立位血压,根据1996年美国自主神经学会和美国神经病学协会制定标准,诊断体位性低血压(OH)和体位性高血压(OHT). 结果 本研究最终纳入老年社区人群377例,其中OH 101例(26.8％),OHT 33例(8.8％).Logistic回归分析在校正多个潜在危险因素后,颈动脉斑块者OH患病风险增加(OR=2.27,95％ CI:1.32～3.90,P=0.003),且存在双侧斑块者OH患病风险增加显著(OR=3.45,95％ CI:1.74～6.84,P=0.001),存在单侧斑块者OH风险并未增加(OR=1.71,95％ CI:0.88～3.32,P=0.112);而无论存在双侧或单侧颈动脉斑块,其OHT的患病风险均未增加. 结论 颈动脉斑块,尤其是双侧颈动脉斑块是社区老年人群发生OH而非OHT的独立危险因素.
目的 觀察老年社區人群頸動脈粥樣硬化斑塊形成與體位性血壓變異的相關性. 方法 採用橫斷麵研究設計,通過現場標準問捲、體格檢查、靜脈血生化檢查穫得受試者基本臨床資料,併行頸動脈超聲檢查明確其是否存在頸動脈斑塊及分佈情況.分彆測定受試者臥、立位血壓,根據1996年美國自主神經學會和美國神經病學協會製定標準,診斷體位性低血壓(OH)和體位性高血壓(OHT). 結果 本研究最終納入老年社區人群377例,其中OH 101例(26.8％),OHT 33例(8.8％).Logistic迴歸分析在校正多箇潛在危險因素後,頸動脈斑塊者OH患病風險增加(OR=2.27,95％ CI:1.32～3.90,P=0.003),且存在雙側斑塊者OH患病風險增加顯著(OR=3.45,95％ CI:1.74～6.84,P=0.001),存在單側斑塊者OH風險併未增加(OR=1.71,95％ CI:0.88～3.32,P=0.112);而無論存在雙側或單側頸動脈斑塊,其OHT的患病風險均未增加. 結論 頸動脈斑塊,尤其是雙側頸動脈斑塊是社區老年人群髮生OH而非OHT的獨立危險因素.
목적 관찰노년사구인군경동맥죽양경화반괴형성여체위성혈압변이적상관성. 방법 채용횡단면연구설계,통과현장표준문권、체격검사、정맥혈생화검사획득수시자기본림상자료,병행경동맥초성검사명학기시부존재경동맥반괴급분포정황.분별측정수시자와、립위혈압,근거1996년미국자주신경학회화미국신경병학협회제정표준,진단체위성저혈압(OH)화체위성고혈압(OHT). 결과 본연구최종납입노년사구인군377례,기중OH 101례(26.8％),OHT 33례(8.8％).Logistic회귀분석재교정다개잠재위험인소후,경동맥반괴자OH환병풍험증가(OR=2.27,95％ CI:1.32～3.90,P=0.003),차존재쌍측반괴자OH환병풍험증가현저(OR=3.45,95％ CI:1.74～6.84,P=0.001),존재단측반괴자OH풍험병미증가(OR=1.71,95％ CI:0.88～3.32,P=0.112);이무론존재쌍측혹단측경동맥반괴,기OHT적환병풍험균미증가. 결론 경동맥반괴,우기시쌍측경동맥반괴시사구노년인군발생OH이비OHT적독립위험인소.
Objective To investigate association between postural changes of blood pressure and carotid atherosclerosis in the elderly.Methods Standardized questionnaires,physical examination and biochemical blood tests were performed to acquire clinical characteristics of the participants.Presences of carotid plaques were identified by carotid ultrasound examination.Orthostatic hypotension (OH) and orthostatic hypertension (OHT) were defined according to the international consensus.Multivariable logistic regression analysis was performed to analyze the associations of carotid plaques with OH and OHT.Results 377 old people were finally included,of which 101 had OH and 33 had OHT.After full adjustment for possible confounders,old people with carotid plaques had significantly increased risk for OH as compared with those without carotid plaques (OR=2.27,95％ CI:1.32-3.90,P=0.003).Participants with bilateral carotid plaques were associated with significantly increased risk for OH (OR=3.45,95％CI:1.74 6.84,P=0.001),while the association between unilateral carotid plaques and OH was not significant (OR=1.71,95％ CI:0.88-3.32,P=0.112).No significant association was identified between carotid plaques (bilateral or unilateral) and OHT.Conclusions Presence of carotid plaques,particularly bilateral plaques,may be an independent risk factor for OH.
