摘要
目的探讨老年高血压住院病人的临床特点及血压治疗情况。方法回顾性分析2013年7月—2015年1月山西大医院心内科住院的老年高血压病人资料,根据年龄分为高龄老年组和低龄老年组,分析两组高血压病人的一般情况、入出院的血压水平、降压药物的服用情况及临床事件发生率;按入院时的收缩压水平将两组病人分为A组(≥150 mm Hg)、B组(<150 mm Hg)。分析各组高血压病人入院、出院的血压水平及降压药物的服用情况。结果与低龄老年组的基线资料比较,高龄老年组高血压病史较长,体重指数、血红蛋白较低,更多病人合并脑血管病、外周动脉疾病、肾功能不全及房颤/房扑。高龄老年组和低龄老年组入院时收缩压(SBP)分别为(140.38±19.51)mm Hg、(139.22±17.71)mm Hg,舒张压(DBP)分别为(74.36±10.15)mm Hg、(76.40±11.13)mm Hg,出院时SBP分别为(129.79±14.31)mm Hg、(128.55±10.79)mm Hg,DBP分别为(72.27±8.16)mm Hg、(72.86±7.76)mm Hg,两组比较收缩压及舒张压水平差异无统计学意义(P>0.05),两组使用降压药物的种类相近,高龄老年组和低龄老年组分别为2.14±1.06、2.13±1.03(P>0.05),两组住院期间的临床事件比较无统计学意义(P>0.05)。高龄老年组和低龄老年组入院时SBP≥150 mm Hg的病人分别占34.97%、31.01%,住院期间SBP、DBP变化幅度较入院时明显(P<0.01),高龄老年组和低龄老年组比较差异无统计学意义(P<0.05)。出院时SBP≥150 mm Hg的病人高龄老年组、低龄老年组分别占13.19%、3.58%,较低血压水平SBP<1 3 0 mm Hg,高龄老年组和低龄老年组分别占4 1.2 1%和4 5.5 8%,DBP≤6 0 mm Hg,高龄老年组和低龄老年组分别占1 3.1 9%、11.73%,两组比较差异无统计学意义(P>0.05)。结论临床工作中对高龄老年高血压的治疗比较积极,降压达标率高,但在治疗中未根据年龄及一般状况进行细化区分,应引起重视。
Objective To investigate the clinical characteristics and antihypertensive therapy in elderly inpatients with hypertension. Methods By retrospective analysis elderly inpatients with hypertension in the Department of Cardiology,Shanxi Dayi Hospital from July 2013 to January2015,according to age divided into very elderly group and young elderly group,analysis the general situation of the two groups of patients with hypertension,admission and discharge blood pressure levels and incidence of clinical events taking antihypertensive drugs;according to the admission systolic blood pressure（ ≥150 mm Hg or 150 mm Hg） of the two groups of patients were divided into group A and group B,to analyze the blood pressure level and the use of antihypertensive drugs in patients with hypertension. Results Compared with the baseline data of the young elderly group,the history of hypertension in the very elderly group was longer,lower hemoglobin,lower body mass index（ BMI）,more patients with cerebral vascular disease,peripheral artery disease,renal insufficiency,atrial flutter and atrial fibrillation. The systolic blood pressure（ SBP） on admission were 140. 38 mm Hg ± 19. 51 mm Hg vs 139. 22 mm Hg ± 17. 71 mm Hg,diastolic blood pressure（ DBP） were74. 36 mm Hg ± 10. 15 mm Hg vs 76. 40 mm Hg ± 11. 13 mm Hg in group A and group B. The discharge SBP were 129. 79 mm Hg ± 14. 31 mm Hg vs 128. 55 mm Hg ± 10. 79 mm Hg,DBP were 72. 27 mm Hg ± 8. 16 mm Hg vs 72. 86 mm Hg ± 7. 76 mm Hg. There was no difference in SBP and DBP levels between two groups（P〈 0. 05）. Similar to the use of antihypertensive drugs in two groups of species,the very elderly and young elderly group were 2. 14 ± 1. 06 vs 2. 13 ± 1. 03（P〈 0. 05）,there was no significant difference in clinical events during hospitalization（P〈 0. 05）. The proportion of patients with more than 150 mm Hg SBP on admission was 34. 97 % and 31. 01 % in two groups,respectively. The changes of hospitalization BP was significant compared with admission BP（P〈 0. 01）,there was no difference between the very elderly and young elderly group（P〈 0. 05）. The proportion of patients with more than 150 mm Hg SBP on discharge was 13. 19 % and 3. 58 % in two groups,respectively. The proportion of patients with less than 130 mm Hg SBP accounted for 41. 21 % and 45. 58 % in the very elderly and young elderly group,respectively. The proportion of patients with less than 60 mm Hg DBP accounted for 13. 19 % and 11. 73 % in the very elderly and young elderly group,respectively. Conclusion In clinical work,the treatment of hypertension in the very elderly is more positive,the control rate of blood pressure is good,but the treatment is not based on age and general situation of specialization. It should be paid attention to.
出处
《中西医结合心脑血管病杂志》
2016年第22期2676-2680,共5页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
关键词
高血压
高龄老年人
低龄老年人
降压治疗
hypertension
very elderly people
young elderly people
antihypertensive therapy
