老年人体位性血压变化与靶器官损害的相关性研究

摘要

目的 观察老年人体位性血压变化的发生率,探讨其与靶器官损害的关系.方法 选择190例老年人,根据体位性血压变化情况分为3组:体位性低血压(OH)组、体位性正常血压(ONT)组和体位性高血压(OHT)组,并进行生化、颈动脉超声、动脉硬化指标检测.结果 190名老年人中OH发生率19.47％,OHT发生率20％.与ONT组相比,OH组患者颈动脉内膜中层厚度(IMT)升高(ONT组和OH组IMT分别为(0.85+0.02)cm、(0.97+0.04) cm,P＜0.05)、肾小球滤过率(CCR)下降(ONT组和OH组CCR分别为(70.68 +2.29)mL/min、(62.14+3.36)mL/rmin,P＜0.05)、肱踝脉搏波传导速度(baPWV)升高(ONT组和OH组baPWV分别为(1872.36+21.17)mln/s、(2165.40+37.01) mm/s,P＜0.05)；而OHT组患者baPWV升高(OHT组baPWV为(2109.45+36.22)mm/s,P＜0.05).结论 老年人OHT与OH患病率较高,体位性血压变化与靶器官损害相关.%Objective To observe the incidence of abnormal orthostatic blood pressure changes and study the relationship between orthostatic blood pressure changes and target organ damage in elderly patients.Methods Blood pressure measurements of 190 elderly patients were obtained in a supine position and within 3 minutes after standing.All cases were divided into orthostatic hypotension (OH) group,orthostatic hypertension (OHT) group and orthostatic normotension (ONT) group according to the blood pressures.Clinical status,biochemical indicators,carotid ultrasound and baPWV were evaluated and analyzed at the same time.Results Among 190 patients,the prevalence of orthostatic hypotension and hypertension was 19.47％and 20％ respectively.Compared to ONT group,intima-media thickness (IMT) of bilateral common carotid arteies significantly increased (IMT of ONT group and OH group were respectively (0.85±0.02) cm and (0.97 +0.04) cm,P＜ 0.05) and endogenous creatinine clearance rote (CCR) declined obviously (CCR of ONT group and OH group were respectively (70.68+2.29) mL/minand (62.14+3.36) mL/min,P＜ 0.05) inOHgroup.BaPWV were higher in OH group than those of in ONT group (baPWV of ONT group and OH group were respectively (1872.36+21.17) mm/s and (2165.40+37.01) mm/s,P＜0.05).PWV were higher in OHT group than those of in ONT group (baPWV of OHT group were (2109.45+36.22) mm/s,P＜0.05).Conclusions Orthostatic hypertension and orthostatic hypotension in elderly patients may have higher risk of developing target organ damage.