高血压病合并主动脉夹层患者降压药物使用及血压控制情况分析

Analysis of the use of antihypertensive drugs and blood pressure control in patients with hypertension complicated with aortic dissection

目的分析高血压病合并主动脉夹层(AD)患者降压药物使用及血压控制情况。方法回顾性选取2019年1月至2021年12月就诊于济宁医学院附属医院急诊科并确诊AD的患者作为研究对象,按照是否有高血压病史分为高血压病组(观察组)和无高血压病组(对照组)。分析2组临床特征、降压方案和血压控制情况等临床资料。结果本研究共纳入314例AD患者,其中227例(72.3%)患者有高血压病史(观察组)、87例患者无高血压病史(对照组)。观察组重症监护病房停留时间长于对照组,差异有统计学意义(P=0.022)。观察组入院时收缩压、入院时平均动脉压(MAP)均高于对照组[(158±32)mmHg(1 mmHg=0.133 kPa)比(148±31)mmHg、(111±25)mmHg比(105±23)mmHg],差异均有统计学意义(均P<0.05)。观察组住院期间静脉泵注硝酸酯类药物比例、三联降压药物比例均高于对照组,差异均有统计学意义(均P<0.05)。观察组出院收缩压、出院MAP均高于对照组,血压达标比例低于对照组,差异均有统计学意义(均P<0.05)。观察组出院后服用钙通道阻滞剂、血管紧张素Ⅱ受体拮抗剂、三联降压药物比例均高于对照组,单药使用比例低于对照组,差异均有统计学意义(均P<0.05)。结论高血压病合并AD患者血压水平更高,更难控制,需联合用药控制血压。

Objective To analyze the use of antihypertensive drugs and blood pressure control in patients with hypertension complicated with aortic dissection(AD).Methods From January 2019 to December 2021,patients who were diagnosed with AD in Department of Emergency,Affiliated Hospital of Jining Medical University were enrolled retrospectively.They were divided into hypertension group(observation group)and non-hypertension group(control group)according to the history of hypertension.The clinical characteristics,antihypertensive schemes and blood pressure control were analyzed in the two groups.Results A total of 314 AD patients were enrolled,included 227 cases(72.3%)with history of hypertension,and 87 cases without history of hypertension.The duration of stay in intensive care unit in the observation group was longer than that in the control group(P=0.022).The systolic pressure and mean arterial pressure(MAP)on admission in the observation group were higher than those in the control group[(158±32)mmHg vs(148±31)mmHg,(111±25)mmHg vs(105±23)mmHg](both P<0.05).The proportions of intravenous nitrates and triple-antihypertensive drugs in the observation group were higher than those in the control group(both P<0.05).The systolic pressure and MAP at discharge in the observation group were higher than those in the control group,and the proportion of blood pressure reached the standard was lower than that in the control group(all P<0.05).After discharge,the proportions of calcium channel blockers,angiotensinⅡreceptor blockers and triple-antihypertensive drugs taken in the observation group were higher than those in the control group,and the proportion of single drug taken was lower than that in the control group(all P<0.05).Conclusion Patients with hypertension complicated with AD have higher blood pressure level,more difficult to control,and require combination medication to control blood pressure.