住院老年患者体位性低血压发生率及相关危险因素初探

目的观察住院老年患者体位性低血压的发病情况及相关危险因素。方法以2009年7月～2011年12月间入住我科的60岁以上老年患者为研究对象,测定卧、立位血压(休息至少5min后的卧位,站立即刻,站立后3min的血压),并采集病史。结果共收集了112例患者的资料,平均年龄(78.23±16.53)岁,其中男42例,女70例。共有31例患者(27.68%)存在体位性低血压。这31例患者中,合并高血压、饮酒、肾功能衰竭、甲状腺功能减退的比率明显高于无体位性低血压患者,而年龄、性别、糖尿病、冠心病、脑卒中、癌症在体位性低血压与非体位性低血压组无显著差异。Logistic逐步回归分析发现高血压与饮酒患者发生体位性低血压的相对危险度(RR)分别为2.7(95%CI1.0～6.8,P=0.04)和3.3(95%CI0.98～9.47,P=0.02)。结论体位性低血压在住院老年患者中比较常见,高血压、饮酒是发生体位性低血压的相关危险因素。

Primary exploration of prevalence and the risk factors of orthostatic hypotension in elderly hospitalized patients

Objective To observe the prevalence and the risk factors of orthostatic hypotension(OH)in elderly hospitalized patients. Methods Chosed elderly hospitalized patients in our hospital from Jul 2009 to Dec 2011. All the patients were taken history and blood pressure in supine position after resting for more than 5 minutes and at 0 and 3 min after standing. Results In 112 elderly patients,mean age 78.23±16.53 years,42 males and 70 females. 31(27.68%) patients had OH. They had a higher prevalence of hypertension, alcoholism, renal failure and hypothyroidism. There were no significant difference in age,gender,diabetes,myocardial ischemia,stroke and cancer between the OH group and non orthostatic hypotension group. The RR of hypertension and alcoholism was 2.7(95%CI 1.0~6.8,P=0.04)and 3.3 (95%CI 0.98～9.47,P=0.02) respectively by Logistic regression analysis. Conclusion Orthostatic hypotension is very common in elderly hospitalized patients. Hypertension and alcoholism are both the risk factors of OH.