直立性低血压与非直立性低血压患者皮质醇水平的比较

Cortisol level in patients with orthostatic hypotension or non-orthostatichypotension: A comparative analysis

目的:观察直立性低血压(OH)患者血清皮质醇水平,探究“肾者,作强之官”的本质及其与OH的关系。方法:收集站立时头晕加重的23例OH患者为OH组,与OH组性别、年龄、共患疾病相匹配的20例非直立性头晕患者为对照组,比较2组卧位平均动脉压(MAP)与心率、立位MAP与心率,以及血清皮质醇水平。结果:组内比较,OH组患者站立3 min时MAP明显下降,心率明显上升,差异有统计学意义(P<0.01);组间比较,OH组患者立位MAP及皮质醇水平较对照组降低,立位心率较对照组上升,差异圴有统计学意义(P<0.05,P<0.01)。结论:OH患者存在皮质醇水平低下,这可能是“肾者,作强之官”功能低下的本质之一。

Objective:To investigate the serum level of cortisol in patients with orthostatic hypotension(OH),as well as the essence of“kidney as an organ with powerful functions”and its association with OH.Methods:A total of 23 OH patients with aggravation of dizziness in the standing position were enrolled as OH group,and 20 non-orthostatic patients with dizziness,matched for sex,age,and comorbidities,were enrolled as control group.The two groups were compared in terms of mean arterial pressure(MAP)and heart rate in the supine position and the standing position and the serum level of cortisol.Results:After standing for 3 minutes,the patients in the OH group had a significant reduction in MAP and a significant increase in heart rate(P<0.01).Compared with the control group,the OH group had significantly lower levels of MAP and cortisol in the standing position and a significant increase in heart rate in the standing position(P<0.05,P<0.01).Conclusion:There is a relatively low level of cortisol in patients with OH,which may be one of the root causes of hypofunction for“kidney as an organ with powerful functions”.