CAJ | 학술논문

目的：分析和探讨老年高血压患者的血压控制现状及影响因素。方法回顾分析我院2013年1月至2015年1月期间的500例老年高血压患者，并按照血压的具体控制情况将患者分为血压控制正常组以及高血压组，其中血压控制正常组包含患者267例，高血压组包含患者233例。对所有的患者进行统一的超声心动图检查，准确测定患者的左心室二尖瓣舒张早期血流峰值、舒张晚期血流峰值、舒张晚期血流比值以及LVEF等具体的指标，然后对测定的指标结果进行比较分析。结果本次研究的500例老年高血压患者，合并1个危险因素的患者占29.00%，合并2个危险因素的患者占25.00%，合并3个以上危险因素的患者占20.80%，危险因素少的患者，血压控制率没有出现明显的增加（χ2=4.125，P=0.356）。高血压组患者合并动脉粥样硬化、心房颤动、冠心病脑卒中以及糖尿病的比率明显高于血压控制正常组。将血压控制的正常与不正常作为二分变量，对于上述的研究因素进行Logistic回归分析，两组患者的动脉粥样硬化、冠心病、BMI、TC、HDL-C和LVWP等指标的禅意有统计学意义。结论老年高血压患者的血压控制状况并没有因为服药数量的增加而逐渐改善，在对老年高血压患者进行治疗的过程中应当从患者的危险因素、生化指标、临床状况以及心脏结构和功能异常等角度进行综合防治。
목적：분석화탐토노년고혈압환자적혈압공제현상급영향인소。방법회고분석아원2013년1월지2015년1월기간적500례노년고혈압환자，병안조혈압적구체공제정황장환자분위혈압공제정상조이급고혈압조，기중혈압공제정상조포함환자267례，고혈압조포함환자233례。대소유적환자진행통일적초성심동도검사，준학측정환자적좌심실이첨판서장조기혈류봉치、서장만기혈류봉치、서장만기혈류비치이급LVEF등구체적지표，연후대측정적지표결과진행비교분석。결과본차연구적500례노년고혈압환자，합병1개위험인소적환자점29.00%，합병2개위험인소적환자점25.00%，합병3개이상위험인소적환자점20.80%，위험인소소적환자，혈압공제솔몰유출현명현적증가（χ2=4.125，P=0.356）。고혈압조환자합병동맥죽양경화、심방전동、관심병뇌졸중이급당뇨병적비솔명현고우혈압공제정상조。장혈압공제적정상여불정상작위이분변량，대우상술적연구인소진행Logistic회귀분석，량조환자적동맥죽양경화、관심병、BMI、TC、HDL-C화LVWP등지표적선의유통계학의의。결론노년고혈압환자적혈압공제상황병몰유인위복약수량적증가이축점개선，재대노년고혈압환자진행치료적과정중응당종환자적위험인소、생화지표、림상상황이급심장결구화공능이상등각도진행종합방치。
Objective To analyze and explore the current situation and influencing factors for blood pressure control in elderly patients with hypertension. Methods The clinical data of 500 elderly patients with hypertension treated in our hospital from January 2013 to January 2015 were analyzed retrospectively, and the patients were divided into the group with normal blood pressure control and the group with hypertension according to the patientˊs actual situation of blood pressure control, with 267 patients in the former group and 233 patients in the latter group. Echocardiography was performed for all patients, and detailed indices including peak blood flow in the early diastolic phase, peak blood flow in the late diastolic phase, and blood flow ratio in the late diastolic phase in the mitral valve of the left ventricule and left ventricular ejection fraction were measured accurately. The results for these indices were analyzed and compared between the two groups. Results Among the 500 elderly patients with hypertension, the patients with one risk factor, two risk factors, and three or more risk factors accounted for 29.00%, 25.00%, and 20.80%, respectively. Blood pressure control rate did not increase significantly in the patients with fewer risk factors (χ2=4.125, P=0.356). The proportion of patients with atherosclerosis, atrial fibrillation, coronary heart disease, stroke, or diabetes in the group with hypertension was higher than that in the group with normal blood pressure control. Logistic regression analysis was performed for the factors above with normal or abnormal blood pressure control as a dichotomous variable, and the result showed that the differences in indices such as atherosclerosis, coronary heart disease, body mass index, cholesterol, high- density lipoprotein cholesterol, and left ventricular posterior wall thickness between the two groups had statistical significance.Conclusion Blood pressure control in elderly patients with hypertension is not improved with the increasing number of drugs, and during the treatment for such patients, comprehensive prevention and treatment should be provided with the patientˊs risk factors, biochemical indices, clinical conditions, and abnormality in cardiac structure and function taken into consideration.