老年体位性低血压患者血压节律特点探讨

Discuss of blood pressure rhythms characteristics of older patients with orthostatic hypotension

目的探讨老年体位性低血压患者血压昼夜节律变化特点。方法对149例老年高血压住院患者进行卧位及立位3 min血压测量,将其分为体位性低血压组(OH组,n=17)及非体位性低血压组(非OH组,n=132)。对两组患者均进行24 h动态血压监测,比较血压昼夜节律变化。结果 OH组夜间平均收缩压及舒张压均高于非OH组(P<0.05),12例(70.6%)OH患者血压昼夜节律以反杓型为主。结论老年体位性低血压患者存在夜间高血压及卧位高血压,血压昼夜节律呈反杓型的特点,临床降压治疗时需酌情调整用药方案。

Objective To investigate the characteristics of blood pressure circadian rhythms changes of older patients with orthostatic hypotension（OH）.Methods Recumbent position and vertical position 3 min blood pressure measurement was proceeded in 149 cases of hospitalized hypertensive patients,and the patients were divided into the OH group（n = 17） and the non-OH group（n = 132）.24 h ambulatory blood pressure monitoring（ABPM） were adopted in patients of the two groups,and the blood pressure circadian rhythms changes were compared.Results Nighttime MSBP and diastolic pressure of the OH group were all higher than those of the non-OH group（P 0.05）.Pattern of reverse-dipper was the main circadian rhythm of blood pressure among 12 cases of OH patients（70.6%）.Conclusion Elderly patients with OH have night hypertension and supine hypertension and the characteristic of circadian rhythm of blood pressure is reverse-dipper,therapeutic regimen should be regulated discretionarily in clinical depressurization therapy.