中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2014年
4期
314-320
,共7页
沈丹彤%谢志泉%潘春梅%钟一新%林仲秋%李志樑
瀋丹彤%謝誌泉%潘春梅%鐘一新%林仲鞦%李誌樑
침단동%사지천%반춘매%종일신%림중추%리지량
低血压,直立性%患病率%症状和体征%诊断
低血壓,直立性%患病率%癥狀和體徵%診斷
저혈압,직립성%환병솔%증상화체정%진단
Hypotension,orthostatic%Prevalence%Symptoms & signs%Diagnosis
目的 明确出现相关症状的人群体位性低血压的患病率及其直立性血压的变化规律,分析症状与直立性血压的联系.方法 因出现体位性低血压相关症状就诊的患者193例入选本研究,将其分为青年组(37例)、中年组(66例)和老年组(90例)共3组.测量患者的身高、体质量、腰围、臀围、卧位心率.对患者进行症状评分.分别在间隔1周以上的2个检查日,2次测量患者的心踝指数(CAVI)和踝臂指数(ABI),分上、下午测量血压共4次,分别测量卧位、不同立位时相的收缩压和舒张压,计算直立性收缩期血压变化(OCs)和直立性舒张期血压变化(OCd).分析体位性低血压患病率、直立性血压变化规律、动脉硬化指数特征,评判目前体位性低血压诊断标准的可重复性,分析症状评分与不同时间的体位性血压变化值的关系.结果 本研究入选病例体位性低血压的患病率为32.6％(63/193),青年组、中年组和老年组的患病率分别为32.4％(12/37)、25.8％(17/66)和37.8％(34/90),组间差异无统计学意义(P＞0.05).仅有9例(占确诊人数14.29％)分别在2次或2次以上的直立性血压检查中都符合体位性低血压的诊断标准.4次直立性血压检查共筛查出体位性低血压患者63例,单次直立性血压检查占19.5％ ～ 57.14％.体位性低血压组与非体位性低血压组比较,年龄、体质量、体质指数、腰臀比、吸烟、饮酒、性别、冠心病、高血压病、帕金森病、脑卒中病史、服用降压药物等因素差异均无统计学意义(P＞0.05),身高、腰围、臀围、心率差异则有统计学意义(P ＜0.05或0.01),体位性低血压组明显偏低.OCs和OCd波动较大,未发现显著规律.体位性低血压组CAVI值(8.37±0.27)与非体位性低血压组(8.45±0.19)比较差异无统计学意义(P＞0.05).OH组ABI值(1.004 ±0.013)明显小于非OH组(1.051±0.009) (P ＜0.01).4次测量的OCs及OCd值与症状评分线性回归分析无统计学意义(F =4.552,P＞0.05).结论 出现相关症状的患者体位性低血压的患病率高.体位性低血压患者直立性血压波动无显著规律,通过反复直立性血压测量可提高检出率.症状与直立性血压变化没有统计学上的联系.
目的 明確齣現相關癥狀的人群體位性低血壓的患病率及其直立性血壓的變化規律,分析癥狀與直立性血壓的聯繫.方法 因齣現體位性低血壓相關癥狀就診的患者193例入選本研究,將其分為青年組(37例)、中年組(66例)和老年組(90例)共3組.測量患者的身高、體質量、腰圍、臀圍、臥位心率.對患者進行癥狀評分.分彆在間隔1週以上的2箇檢查日,2次測量患者的心踝指數(CAVI)和踝臂指數(ABI),分上、下午測量血壓共4次,分彆測量臥位、不同立位時相的收縮壓和舒張壓,計算直立性收縮期血壓變化(OCs)和直立性舒張期血壓變化(OCd).分析體位性低血壓患病率、直立性血壓變化規律、動脈硬化指數特徵,評判目前體位性低血壓診斷標準的可重複性,分析癥狀評分與不同時間的體位性血壓變化值的關繫.結果 本研究入選病例體位性低血壓的患病率為32.6％(63/193),青年組、中年組和老年組的患病率分彆為32.4％(12/37)、25.8％(17/66)和37.8％(34/90),組間差異無統計學意義(P＞0.05).僅有9例(佔確診人數14.29％)分彆在2次或2次以上的直立性血壓檢查中都符閤體位性低血壓的診斷標準.4次直立性血壓檢查共篩查齣體位性低血壓患者63例,單次直立性血壓檢查佔19.5％ ～ 57.14％.體位性低血壓組與非體位性低血壓組比較,年齡、體質量、體質指數、腰臀比、吸煙、飲酒、性彆、冠心病、高血壓病、帕金森病、腦卒中病史、服用降壓藥物等因素差異均無統計學意義(P＞0.05),身高、腰圍、臀圍、心率差異則有統計學意義(P ＜0.05或0.01),體位性低血壓組明顯偏低.OCs和OCd波動較大,未髮現顯著規律.體位性低血壓組CAVI值(8.37±0.27)與非體位性低血壓組(8.45±0.19)比較差異無統計學意義(P＞0.05).OH組ABI值(1.004 ±0.013)明顯小于非OH組(1.051±0.009) (P ＜0.01).4次測量的OCs及OCd值與癥狀評分線性迴歸分析無統計學意義(F =4.552,P＞0.05).結論 齣現相關癥狀的患者體位性低血壓的患病率高.體位性低血壓患者直立性血壓波動無顯著規律,通過反複直立性血壓測量可提高檢齣率.癥狀與直立性血壓變化沒有統計學上的聯繫.
목적 명학출현상관증상적인군체위성저혈압적환병솔급기직립성혈압적변화규률,분석증상여직립성혈압적련계.방법 인출현체위성저혈압상관증상취진적환자193례입선본연구,장기분위청년조(37례)、중년조(66례)화노년조(90례)공3조.측량환자적신고、체질량、요위、둔위、와위심솔.대환자진행증상평분.분별재간격1주이상적2개검사일,2차측량환자적심과지수(CAVI)화과비지수(ABI),분상、하오측량혈압공4차,분별측량와위、불동립위시상적수축압화서장압,계산직립성수축기혈압변화(OCs)화직립성서장기혈압변화(OCd).분석체위성저혈압환병솔、직립성혈압변화규률、동맥경화지수특정,평판목전체위성저혈압진단표준적가중복성,분석증상평분여불동시간적체위성혈압변화치적관계.결과 본연구입선병례체위성저혈압적환병솔위32.6％(63/193),청년조、중년조화노년조적환병솔분별위32.4％(12/37)、25.8％(17/66)화37.8％(34/90),조간차이무통계학의의(P＞0.05).부유9례(점학진인수14.29％)분별재2차혹2차이상적직립성혈압검사중도부합체위성저혈압적진단표준.4차직립성혈압검사공사사출체위성저혈압환자63례,단차직립성혈압검사점19.5％ ～ 57.14％.체위성저혈압조여비체위성저혈압조비교,년령、체질량、체질지수、요둔비、흡연、음주、성별、관심병、고혈압병、파금삼병、뇌졸중병사、복용강압약물등인소차이균무통계학의의(P＞0.05),신고、요위、둔위、심솔차이칙유통계학의의(P ＜0.05혹0.01),체위성저혈압조명현편저.OCs화OCd파동교대,미발현현저규률.체위성저혈압조CAVI치(8.37±0.27)여비체위성저혈압조(8.45±0.19)비교차이무통계학의의(P＞0.05).OH조ABI치(1.004 ±0.013)명현소우비OH조(1.051±0.009) (P ＜0.01).4차측량적OCs급OCd치여증상평분선성회귀분석무통계학의의(F =4.552,P＞0.05).결론 출현상관증상적환자체위성저혈압적환병솔고.체위성저혈압환자직립성혈압파동무현저규률,통과반복직립성혈압측량가제고검출솔.증상여직립성혈압변화몰유통계학상적련계.
Objective To analyze the prevalence and orthostatic blood pressure changes in subjects with symptomatic orthostatic hypotension (OH),and to observe the relation between symptoms and orthostatic blood pressure change in this population.Methods A total of 193 subjects who consulted physicians due to OH related symptoms were selected,and divided into three groups:young (n =37),middle-aged (n =66) and elder (n =90).Height,body weight,waist circumference,hip circumference and resting heart rate were measured.Symptom scores of every subject were obtained.CAVI and ABI were measured.Blood pressure including recumbent position,orthostatic systolic and diastolic blood pressure was measured at the morning and at the afternoon on two separate examination days with at least one week interval.After that,orthostatic changes in systolic blood pressure (OCs) and orthostatic changes in diastolic blood pressure (OCd) were calculated.Results OH prevalence was 32.6％ in this cohort.The prevalence of three groups was similar [young:32.4％,middle-aged:25.8％,and elderly:37.8％,respectively (P ＞0.05)].Only 9 cases (14.29％ of confirmed OH cases) reached the OH diagnostic criteria with equal or more than 2 times orthostatic blood pressure measurements.OH was diagnosed in 63 patients during the 4 times orthostatic blood pressure check,of which 19.5％ to 57.14％ cases were diagnosed with single orthostatic blood pressure check.Age,weight,body mass index,waist-to-hip ratio,smoking,drinking habit,sex,coronary heart disease,hypertension,Parkinson's disease,stroke history,antihypertensive drug use were similar between OH group and non-OH group.Height,waist circumference,hip circumference,and resting heart rate were significantly lower in OH group than in non-OH group (P ＜ 0.05).The values of the factors in OH group were lower.CAVI was 8.45 ±0.19 in non-OH group and 8.37 ±0.27 in OH group (P ＞ 0.05),ABI was significantly lower in OH group than in non-OH group (1.004 ± 0.013 vs.1.051 ± 0.009,P ＜ 0.01).Conclusion The prevalence of OH in people with related symptoms is high.Repeated orthostatic blood pressure measurements can improve OH detection rate.
