本文選題：餐后低血壓 + 原發(fā)性高血壓　； 參考：《中華高血壓雜志》2017年02期

【摘要】：目的觀察住院老年原發(fā)性高血壓患者餐后血壓變化,探討餐后低血壓(PPH)臨床特點(diǎn)及其與心、腎等靶器官損害的相關(guān)性。方法選取2013年3月至2014年10月大連醫(yī)科大學(xué)附屬第一醫(yī)院高血壓病房住院治療的老年原發(fā)性高血壓患者191例,行24h動(dòng)態(tài)血壓監(jiān)測,根據(jù)PPH診斷標(biāo)準(zhǔn)分為PPH組(n=153)和非PPH組(NPPH組,n=38),探討PPH臨床特點(diǎn)及相關(guān)因素。行心臟超聲、腎功能檢查,探討PPH對心臟及腎臟損害的影響。結(jié)果住院老年原發(fā)性高血壓患者191例中,153例在不同餐次出現(xiàn)至少一次PPH,PPH總發(fā)生率80.1%。早餐及午餐PPH發(fā)生率高于晚餐(P0.05);早餐、午餐餐后收縮壓下降幅度大于晚餐[(18.3±14.9)、(20.3±14.6)比(15.5±13.0)mm Hg,均P0.05],三餐后舒張壓下降幅度差異無統(tǒng)計(jì)學(xué)意義(P0.05)。不同年齡組PPH發(fā)生率差異無統(tǒng)計(jì)學(xué)意義,但80~89歲高齡老年組早餐后收縮壓下降幅度較60~69歲低齡老年組增大[(26.3±12.1)比(16.8±15.0)mm Hg,P0.05]。根據(jù)三餐的餐前收縮壓之和取平均值分為3組,餐前平均收縮壓較高的C組(≥160mm Hg)與B組(140~160mm Hg)的PPH發(fā)生率高于收縮壓較低的A組(140mm Hg)(P0.05);且C組和B組三餐后收縮壓下降幅度高于A組。多因素Logistic回歸分析顯示,三餐餐前平均收縮壓是PPH發(fā)生的獨(dú)立影響因素(OR1.050,95%CI 1.021~1.079)。PPH組左心室質(zhì)量指數(shù)大于NPPH組(P0.05),而PPH組與NPPH組在腎功能方面的差異無統(tǒng)計(jì)學(xué)意義。結(jié)論住院老年原發(fā)性高血壓患者的PPH發(fā)生率為80.1%,三餐中以早餐及午餐PPH發(fā)生率較高,晚餐PPH發(fā)生率最低;三餐餐前平均收縮壓是住院老年原發(fā)性高血壓患者PPH發(fā)生的獨(dú)立影響因素;PPH的發(fā)生可能會(huì)引起住院老年原發(fā)性高血壓患者左心室結(jié)構(gòu)的改變。
[Abstract]:Objective to observe the changes of postprandial blood pressure (PPH) in elderly patients with essential hypertension (EH), and to explore the relationship between PPH and heart, kidney and other target organ damage. Methods 191 elderly patients with essential hypertension in hypertension ward of the first affiliated Hospital of Dalian Medical University from March 2013 to October 2014 were selected for 24 hours ambulatory blood pressure monitoring. According to the diagnostic criteria of PPH, the patients were divided into PPH group (n = 153) and non-PPH group (n = 38). The clinical features and related factors of PPH were discussed. The effects of PPH on heart and kidney damage were studied by echocardiography and renal function examination. Results the total incidence of PPH was 80.1 in 153 of 191 inpatients with essential hypertension at least once at different meals. The incidence of PPH in breakfast and lunch was higher than that in dinner (P 0.05), and the decrease of systolic blood pressure after breakfast was greater than that in dinner [18.3 鹵14.9g 20.3 鹵14.6] compared with 15.5 鹵13.0)mm Hg (P0.05). There was no significant difference in the decrease of diastolic blood pressure (P 0.05). There was no significant difference in the incidence of PPH among different age groups, but the decrease of systolic blood pressure (SBP) after breakfast in the aged group aged 80 to 89 was higher than that in the young group aged 60 ~ 69 years [26.3 鹵12.1 vs 16.8 鹵15.0)mm Hg0. 05]. According to the sum of preprandial systolic blood pressure at three meals, they were divided into three groups. The incidence of PPH in group C (鈮，

本文編號(hào)：1893484