老年卧位高血压患者体位性低血压发生情况与营养状况的相关性-现代医学

老年卧位高血压患者体位性低血压发生情况与营养状况的相关性

单位：1. 西安交通大学第二附属医院全科医学科, 陕西西安 710004;
2. 中国医科大学附属第一医院全科医学科, 辽宁沈阳 110001

分类号：R544

出版年·卷·期（页码）：2023·51·第七期（895-899）

摘要：

目的: 探究老年卧位高血压患者体位性低血压(OH)发生情况及其与患者营养状况的相关性。方法: 以2017年10月至2022年10月在我院就诊的142例卧位高血压患者为对象,整理其性别、年龄、体质量指数(BMI)等资料,测量其平卧位和直立位收缩压、舒张压;营养风险筛查NRS(2002)评估表评估患者营养状况。依据平卧位转向直立位3 min时的收缩压、舒张压下降情况判断是否有OH发生,并据此将患者分为非OH组和OH组。比较分析老年平卧位高血压患者OH发生与营养状况的相关性。结果: 本研究老年卧位高血压患者OH发生率达37.32%,患者中18.31%表现为营养不良,23.24%存在营养不良风险。OH组年龄、冠心病率、贫血率、平卧位收缩压、平卧位舒张压、营养不良率均明显高于非OH组,BMI、直立位收缩压、直立位舒张压、营养正常者占比均明显低于非OH组(P<0.05)。Pearson相关性分析显示,平卧位转向直立位收缩压差值和舒张压差值均与NRS(2002)评分呈负相关(P<0.01)。Logistic回归分析显示,老年卧位高血压患者BMI、直立位收缩压和舒张压是OH发生的保护性因素,冠心病、贫血、平卧位收缩压、平卧位舒张压、营养不良为影响OH发生的危险因素(P<0.05)。结论: 老年卧位高血压患者OH患病率较高,营养不良会增加老年卧位高血压患者OH发生风险。

Objective: To investigate the occurrence of postural hypotension(OH) and its correlation with nutritional status in elderly patients with recumbent hypertension. Method: 142 patients with supine hypertension admitted to our hospital from October 2017 to October 2022 were selected as subjects, and the data such as sex, age and body mass index(BMI) were collected, and their systolic and diastolic blood pressure in supine and upright positions were measured, and the Nutritional Risk Screening NRS(2002) assessment forms were used to assess the nutritional status of patients. The occurrence of OH was determined according to the decrease of systolic and diastolic blood pressure when the supine position shifted to the upright position for 3 minutes, and then the patients were divided into non-OH group and OH group. The correlation between OH occurrence and nutritional status in elderly supine hypertension patients was analyzed. Results: Among the included elderly patients with supine hypertension, the incidence of OH was 37.32%, the malnutrition rate was 18.31% and the malnutrition risk rate was 23.24%. Age, coronary heart disease rate, anemia rate, supine systolic blood pressure, supine diastolic blood pressure and malnutrition rate in the OH group were significantly higher than those in the non-OH group, while BMI, upright systolic blood pressure, upright diastolic blood pressure and the proportion of normal nutrition in OH group were significantly lower than those in the non-OH group(P<0.05). Pearson correlation analysis showed that both systolic and diastolic blood pressure differences from supine to upright position were negatively correlated with NRS(2002) score (P<0.01). Logistic regression analysis showed that BMI, upright systolic blood pressure and diastolic blood pressure were protective factors for the occurrence of OH in elderly patients with recumbent hypertension, while coronary heart disease, anemia, supine systolic blood pressure, supine diastolic blood pressure and malnutrition were risk factors for the occurrence of OH(P<0.05). Conclusion: The prevalence of OH in elderly patients with recumbent hypertension is higher, and malnutrition will increase the risk of OH in elderly patients with recumbent hypertension.

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