摘要
目的研究心血管内科住院患者体位性低血压(OH)的影响因素。方法对2012年7—8月北京大学人民医院心血管内科200例住院患者进行卧位及站立位0、1、2和3 min的血压测量。比较OH组和非OH组患者基线资料、伴随疾病及治疗用药的差异,并分析OH的影响因素。结果共有48例患者(24%)出现了OH,OH组患者卧位收缩压和舒张压均高于非OH组(P=0.001)。与非OH组相比,OH组患者伴发糖尿病(31.3%对10.5%,P=0.001)、脑卒中(27.1%对9.9%,P=0.003)的比例明显增高。OH组患者应用α受体阻滞剂(12.5%对2.6%,P=0.014)、精神类药物(16.7%对5.3%,P=0.011)、降糖药物(27.1%对10.5%,P=0.005)及抗血小板药物(68.8%对52.0%,P=0.041)的比例均高于非OH组。多因素分析后发现,OH的发生与糖尿病(OR=3.84,95%CI 1.63～9.043)、脑卒中(OR=3.469,95%CI 1.409～8.542)、α受体阻滞剂(OR=5.537,95%CI 1.354～22.643)、精神类药物(OR=3.292,95%CI 1.035～10.471)的应用相关。结论 OH在心血管内科住院患者中较常见,伴发糖尿病、脑卒中,应用α受体阻滞剂和精神类药物均可增加发生OH的风险。
Objective To determine the influencing factors of orthostatic hypotension （OH） in inpatients of cardiology. Methods A total of 200 patients hospitalized in cardiology of Peking University People＇s Hospital from July to August 2012 were included. The orthostatic blood pressures were measured in supine position after resting for more than 5 rain and at 0 min, 1 min,2 min and 3 min after standing. Subjects were divided into OH-positive and OH-negative group. The baseline da- ta, eomorhidities and treatment medication differences were compared between the two groups, and the influencing factors of OH were analyzed. Results The prevalence of OH in subjects was 24%. Both the supine systolic and diastolic blood pres- sures were higher in the OH-positive group than those in the OH-negative group （P = 0. 001 ）. The prevalence rates of dia- betes （31.3% vs 10. 5% ,P =0. 001 ） and stroke （27.1% vs 9. 9% , P = 0. 003 ） were higher in the OH-positive group than the OH-negative group. The proportions of application of a receptor blockers （ 12. 5 % vs 2. 6% ,P = 0. 014 ） , psycho- tropic drugs （ 16. 7% vs 5.3% , P = 0. 011 ）, hypoglycemic drugs （ 27.1% vs 10. 5% , P = 0. 005 ） and antiplatelet drugs （68.8% vs 52% ,P =0. 041 ） were higher in the OH-positive group than those in the OH-negative group. Logistic regres- sion showed that the risk of OH was related to diabetes （ OR = 3.84,95% CI 1.63 - 9. 043） , stroke （ OR = 3.469,95% CI 1. 409- 8. 542）,and application of a receptor blockers （OR = 5. 537,95% CI 1. 354 -22. 643 ） and psychotropic drugs （ OR = 3. 292,95% CI 1. 035 - 10. 471 ）. Conclusion OH is common in hospitalized patients. Diabetes mellitus, stroke and application of a receptor blockers and psychotropic drugs may increase the risk of OH.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2013年第5期381-384,共4页
Chinese Journal of Practical Internal Medicine
基金
国家自然科学基金(81270274)
