氟氢可的松联合心痛定治疗直立位低血压伴卧位高血压

摘要

目的：观察氟氢可的松联合心痛定治疗老年性直立位低血压伴卧位高血压的临床疗效。方法：85例患者随机分为对照组42例，给予系统物理疗法；试验组43例，在系统物理疗法的基础上白天给予氟氢可的松扩容升压，夜间给予心痛定扩血管降压。记录治疗d30的白天及夜间的动态血压和低血压所致低灌注以及卧位高血压所致头痛等不适反应。结果：试验组治疗后：①白天平均收缩压较对照组明显增高；且夜间平均收缩压较对照组明显降低，差异均有显著统计学意义（P<0.001）。②白天由于直立位低血压导致低灌注症状发生率20.9%较对照组50.0%明显降低；夜间因高血压所致头痛等不适反应发生率16.3%较对照组38.1%亦明显降低，差异均有显著统计学意义（P值分别为0.004，0.015）。结论：对于直立位低血压伴卧位高血压的患者，在系统物理疗法的基础上，联合应用氟氢可的松、心痛定，疗效确切，可明显改善患者上述的症状。%Objective :To observe the effects fludrocortisone plus nifedipine on elderly orthostatic hypotension complicating supine hypertension. Methods:A total of 85 patients were randomly assigned to either control group(n=42)or trial group(n=43). On day 30,the occurrence of cerebral hypoperfusion induced by hypotension and headache induced by hypertension were observed. Results:The mean systolic pressure during daytime was significantly higher in the treatment group than in the control group;The mean systolic pressure during nighttime was significantly lower in the trial group than control group, P<0.001. The incidence of syncope or cataplexy 20.9%due to cerebral hypoperfusion in day time was significantly less than in the control group 50.0 %; the incidence of headache due to hypertension 16.3%was also significantly less than in the control 38.1%,(P=0.004,0.015). Conclusion:Fludrocortisone plus nifedipine in combination with comprehensive therapy is safe and effective in the treatment of elderly patients with orthostatic hypotension complicating supine hypertension, and by which, patients’ daytime hypotension and nighttime hypertension are all under effective contro1.