【摘要】：目的:觀察原發(fā)性高血壓患者進(jìn)食早餐后血壓變化的規(guī)律;探討餐后低血壓與服用降壓藥時(shí)間的關(guān)系。方法:選取住院的原發(fā)性高血壓患者54例,其中男患者30例,女患者24例,平均年齡為58.9±11.1歲,平均病程為6.9±5.8年,入選前所有患者均在接受口服降壓藥治療,且服藥時(shí)間均包含早餐前。監(jiān)測(cè)患者早、午餐前5分鐘及餐后2小時(shí)內(nèi)每間隔15分鐘的血壓和心率。根據(jù)早餐后收縮壓最大下降幅度將患者分為餐后低血壓組(PPH,n=20)和非餐后低血壓組(NPPH,n=34)。分析各組間生化指標(biāo)及心臟超聲心動(dòng)圖各指標(biāo)有無(wú)差異。并將早餐前服藥出現(xiàn)PPH現(xiàn)象患者的服藥時(shí)間調(diào)整為早餐后2小時(shí),再次監(jiān)測(cè)餐后2小時(shí)服藥EH患者早、午餐前后血壓及心率,并與早餐前服藥EH患者的血壓及心率情況進(jìn)行統(tǒng)計(jì)分析。結(jié)果:入選的EH住院患者早、午餐后PPH的檢出率分別為37.04%、28.26%。隨著年齡的增長(zhǎng)和早餐前基礎(chǔ)收縮壓水平的升高,PPH的檢出率和餐后收縮壓最大下降幅度增加(P0.05)。調(diào)整PPH組患者服藥時(shí)間后,早、午餐PPH的檢出率分別顯著降低至30.00%、25.00%(P0.05)。相關(guān)分析顯示年齡與早餐后收縮壓最大下降幅度呈正相關(guān)(r=0.515,P0.05);餐前SBP與早餐后SBP最大下降幅度呈正相關(guān)(r=0.609,P0.01)。Logistic回歸分析顯示年齡、早餐前基礎(chǔ)收縮壓是原發(fā)性高血壓住院患者發(fā)生PPH的獨(dú)立危險(xiǎn)因素。結(jié)論:原發(fā)性高血壓住院患者早餐后發(fā)生PPH的概率較高。早餐后2小時(shí)服用降壓藥可能會(huì)降低原發(fā)性高血壓住院患者PPH的檢出率。年齡和早餐前基礎(chǔ)收縮壓是原發(fā)性高血壓住院患者PPH發(fā)生的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to observe the changes of blood pressure in patients with essential hypertension after breakfast and to explore the relationship between postprandial hypotension and the time of taking antihypertensive drugs. Methods: 54 hospitalized patients with essential hypertension were selected, including 30 males and 24 females, with an average age of 58.9 鹵11.1 years and an average course of disease of 6.9 鹵5.8 years. All patients were treated with oral antihypertensive drugs before admission. And the time of taking medicine includes before breakfast. Blood pressure and heart rate were monitored at intervals of 15 minutes before lunch and 2 hours after lunch. According to the maximum decrease of systolic blood pressure after breakfast, the patients were divided into postprandial hypotension group (PPH,n=20) and non-postprandial hypotension group (NPPH,n=34). The differences of biochemical indexes and cardiac echocardiography between the two groups were analyzed. The medication time of patients with PPH phenomenon before breakfast was adjusted to 2 hours after breakfast, and the blood pressure and heart rate of patients taking EH 2 hours after breakfast were monitored again. The blood pressure and heart rate of patients with EH before breakfast were statistically analyzed. Results: the detection rates of PPH in patients with EH were 37.04% and 28.26% respectively after lunch. With the increase of age and the increase of basal systolic blood pressure before breakfast, the detection rate of PPH and the maximum decrease of postmeal systolic blood pressure increased (P 0.05). After adjusting the medication time of patients in PPH group, the detection rate of PPH in brunch and lunch was significantly reduced to 30.00% and 25.00% respectively (P 0.05). Correlation analysis showed that age was positively correlated with the maximum decrease of systolic blood pressure after breakfast (r 鈮，

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