住院老年人餐后低血压的临床研究

Clinical investigation of postprandial hypotension of senile inpatients

目的了解住院老年人餐后低血压(PPH)的发生率和临床特点。方法选取2013年6—11月在老年病科住院治疗且病情平稳的71例老年患者,采用24 h动态血压仪测定三餐前后血压和心率。结果住院老年人PPH发生率为87.32%,早、中、晚餐之间PPH发生率无明显差异,亦未发现年龄、性别与PPH发生有关;同时使用≥3种药物或同时患有≥3种基础疾病者,PPH发生率明显增高(P<0.05);三餐后血压均出现不同程度的下降,早餐后血压下降最快且幅度最大,早餐后血压最低值出现于餐后60 min,而午、晚餐则以餐后120 min血压下降幅度最大。三餐后心率均较餐前有所下降,三餐之间心率变化的差异无统计学意义(P>0.05)。结论住院老年人PPH发生率高且餐后血压下降幅度较大,应加以重视,防止因低血压引起不良事件发生。

Objective To explore the prevalence and clinical characteristics of postprandial hypotension（PPH） of senile inpatients. Methods Seventy-one senile patients who were in stable condition and treated in the Department of Geriatrics from June, 2013 to November, 2013 were selected. Their blood pressure and heart rates were measured by the 24 h ambulatory blood pressure monitoring before and after three meals. Results The prevalence of PPH of senile in patients was 87. 320/0, which was irrelevant to age and sex. The prevalences of PPH after breakfast, lunch, and supper were similar. The prevalence of patients with more than three basic diseases or taking more than three drugs was significantly higher （P d0.05）. The blood pressure dropped in varying degrees after three meals. The blood pressure dropped fast and most after breakfast. The lowest blood pressure occurred 60 rain after breakfast and 120 rain after lunch and supper. The heart rates dropped after three meals. The differences of variations of the heart rates before and after three meals were not statistically significant （P〉0.05）. Conclusion The prevalence of PPH of senile inpatients is high and the blood pressure drops significantly after meals. Attention should be paid in order to avoid adverse events induced by the hypotension.