餐后低血压及糖尿病对其发病机制和治疗的影响研究进展

Advances in Postprandial Hypotension and the Impact of Diabetes Mellitus on Its Pathogenesis and Treatment

餐后低血压指餐后2 h内收缩压下降20 mm Hg以上,多见于老年人群、糖尿病患者、帕金森症患者等,与老年人摔倒、心血管意外、全因死亡率等相关。目前认为其发病机制与自主神经功能减退、胃排空加速等有关,这些病理表现也常见于糖尿病患者;同时,降糖药物对餐后低血压也有影响。本文就餐后低血压的流行病学特征、危险因素、发病机制、临床特点及治疗方法进行综述,重点阐述糖尿病对其发病机制的影响和不同降糖药物的治疗效果,为餐后低血压合并糖尿病的预防及治疗提供参考。

Postprandial hypotension(PPH)is defined as a drop in systolic blood pressure of over 20 mm Hg within 2 hours after a meal,which is common among older adults as well as patients with diabetes mellitus,Parkinson disease,and other chronic diseases.It is associated with falls,cardiovascular events,and all-cause mortality in the elderly.In addition to being considered to have associations with the pathogenesis of PPH,decreased autonomic function and accelerated gastric emptying are common pathological changes in diabetes mellitus.Glucose-lowering drugs have also been shown to affect PPH.This review discusses the epidemiology,risk factors,pathogenesis,clinical manifestations,and treatment of PPH,mainly focusing on the possible association of diabetes and PPH pathogenesis as well as therapeutic efficacies of glucose-lowering drugs,aiming to provide guidance for the prevention and treatment of PPH in diabetics.