老年高血压患者变换体位造成血压改变的特点及其并存神经认知障碍的临床分析

Analysis of blood pressure change caused by postural transform and neurocognitive disorder in elderly hypertensive patients

目的探讨老年高血压患者体位性血压改变的特点及其并存神经认知障碍的情况。方法选取2013年12月至2014年12月间在本院住院就诊的老年高血压患者110例,对其进行卧立位血压测量,并对其体位性血压进行分类判断,同时对其是否并存神经认知障碍进行检测。结果在110例老年高血压患者中,23例为体位性低血压(OH组),11例为体位性高血压(OHT组),76例为体位性正常血压(ONT组);3组间性别、年龄以及卧位舒张压比较,差异均无统计学意义(P>0.05);OH组患者的卧位收缩压显著性高于ONT组和OHT组(P<0.01);OH组患者的立位收缩压和舒张压均显著性低于ONT组和OHT组(P<0.01);OH组患者神经认知障碍发生率为47.83%;OHT组患者神经认知障碍发生率为18.18%;ONT组患者神经认知障碍发生率为7.89%,OH组患者的神经认知障碍的发生率显著高于OHT组和ONT组,差异有统计学意义(P<0.05)。结论老年高血压患者变换体位容易出现OH,且OH患者中并存神经认知障碍的比例更高。

Objective To explore the change of blood pressure caused by postural transform, and to investigate the neurocognitive disorder in elderly hypertensive patients. Methods 110 elderly hypertensive patients in our hospital were selected from December 2013 to December 2014. The blood pressure of clinostatic and standing position were measured, and the type of postural blood pressure was classified. Neurocognitive disorder was analyzed. Results Of 110 cases of elderly patients with hypertension, 23 cases showed orthostatie hypotension （OH group）, 11 cases showed orthostatic hypertension （ OHT group） , 76 cases showed normal postural blood pressure （ ONT group）. The differences in gender, age and diastolic blood pressure of elinostatism were not statistically significant between the three groups（P〉 0. 05）. The clinostatic systolic blood pressure of OH group was significantly higher than that of OHT group and ONT group （P〈0.01） ; The systolic and diastolic blood pressure of standing position in OH group were significantly lower than those in ONT group and OHT group （P〈0.01）. Eleven cases （47.83%） suffered from neurocognitive disorders in OH group, 2 cases （18.18%） in OHT group, and 6 cases （7.89%） in ONT group. The incidentce rate of coexisting neurocognitive disorde in OH group was sig- nificantly higher than that in OHT group and ONT group （ P〈0. 05 ）. Conclusions Elderly hypertensive patients are easy to appear orthostatic hypotension caused by postural transform, and the incidence rate of coexisting neurocognitive impair- ments was much higher.