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目的分析高龄老年餐后低血压(PPH)的临床特点,并制定防治策略。方法选取该院干部病房2015年12月-2016年12月收治的老年患者360例,均行24 h动态血压监测。按照年龄划分为2组,60~79岁为普通老年组(n=172),≥80岁为高龄老年组(n=188),应用携带式动态血压监测仪于餐前30 min与餐后每15 min测量1次血压值,比较2组餐后低血压的临床特点,并据此提出防治策略。结果高龄老年组早餐PPH发生率为37.8%、中餐为34.6%均高于晚餐的21.3%(P<0.05);普通老年组3餐PPH发生率比较差异无统计学意义(P>0.05)。高龄老年组PPH总检出率为63.8%高于普通老年组的55.2%(P<0.05);2组高血压PPH检出率高于非高血压检出率(P<0.05);高血压PPH总检出率为65.2%高于非高血压41.7%(P<0.05)。2组患者应用ARB、ACEI、β受体阻滞剂、硝酸酯类及钙拮抗剂药物后PPH发生率均低于同组利尿剂PPH发生率(P<0.05)。结论高龄老年PPH以早中餐后发生率较高,高血压及应用降压药物会提升PPH发生率,需强化干预。
Objective To analyze the clinical features of senile postprandial hypotension (PPH) and to develop prevention and treatment strategies. Methods A total of 360 elderly patients aged from December 2015 to December 2016 were selected and monitored for ambulatory blood pressure 24 hours. The patients were divided into two groups according to their age, 60-79 years old (n = 172) and 80 years old (n = 188). The ambulatory blood pressure monitor The blood pressure was measured at 15 min and the clinical features of postprandial hypotension were compared between the two groups. Based on this, the prevention and cure strategies were proposed. Results The prevalence of PPH was 37.8% in breakfast group and 34.6% in Chinese elderly group compared with 21.3% in dinner group (P <0.05). There was no significant difference in the incidence of PPH among the three elderly patients (P> 0.05). The detection rate of PPH in elderly senile group was 63.8%, higher than 55.2% in normal senile group (P <0.05). The detection rate of PPH in two groups was higher than that in non-hypertensive group (P <0.05) The overall detection rate was 65.2% higher than non-hypertension 41.7% (P <0.05). The incidence of PPH in ARG, ACEI, β-blockers, nitrates and calcium antagonists in both groups was lower than that of the same group of diuretics (P <0.05). Conclusion The incidence of PPH in elderly senile patients is higher than that in early postprandial Chinese people. Hypertension and the use of antihypertensive drugs may increase the incidence of PPH. Intensive intervention is needed.