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肥胖或超重冠心病住院患者餐后低血压的临床观察 预览

The clinical observation of postprandial hypotension in patients with obesity or overweight and coronary heart disease
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摘要 目的观察住院肥胖或超重冠心病患者餐后低血压(prognosis for postprandial hypotension,PPH)的发病率、临床特征、相关影响因素、住院期间不良事件及中期预后。方法152例肥胖或超重冠心病患者,行24h动态血压监测,依据PPH诊断标准分为PPH组(n=37)和NPPH组(n=115),对比2组临床特征、PPH相关危险因素、不良事件发生情况及随访26个月全因死亡、心脑血管等不良事件的预后。结果152例肥胖或超重冠心病患者中发生PPH37例(24.3%),PPH组合并高血压病史和服用钙离子拮抗剂药物比例高于NPPH组;三餐中早餐和晚餐后PPH发生率较午餐高;Logistic回归分析显示,基础收缩压水平、利尿剂与PPH发生呈正相关;2组住院期间发生心脑血管事件差异无统计学意义;随访26个月结果表明,PPH组全因死亡率高于NPPH组。结论肥胖或超重冠心病患者住院期间PPH发生率为24.3%,早餐和晚餐后容易发生PPH,基础收缩压水平高和口服利尿剂增加PPH的发生,PPH增加患者中期全因死亡。 Objective To investigate the incidence rate,clinical features,risk factors and adverse events during hospitalization and mid-term prognosis for postprandial hypotension(PPH)in obesity or overweight patients with coronary heart disease(CHD).Methods A total of 152 obesity or overweight patients with CHD were selected as the subjects.The blood pressure of patients were monitored by 24 hour ambulatory blood pressure monitor.Subjects were classified into PPH group(n=37)and nonPPH group(NPPH,n=115)according according to PPH diagnostic criteriae.The clinical characteristics of the two groups were compared and the risk factors of PPH,the incidence rate of adverse events and the prognosis of all-cause death,cardiovascular and cerebrovascular adverse events were studied.Results Among 152 obese or overweight patients with CHD,37 cases had PPH,the incidence was 24.3%.The proportion of combined with hypertension and taking calcium antagonists in PPH group was higher than that of NPPH group.The incidence rate of PPH at breakfast and dinner was higher than that at lunch.Logistic regression analysis showed that high systolic blood pressure level and oral diuretics were positively correlated with the occurrence of PPH.There was no significant difference in the incidence rate of cardiovascular and cerebrovascular events between the two groups during hospitalization.The 26-month follow up showed that the incidence of all-cause mortality in PPH group was higher than that in NPPH group.Conclusion The incidence rate of PPH in obese or overweight patients with CHD was 24.3%.PPH might be likely to occur after breakfast and dinner.High systolic blood pressure and oral diuretics might increase the incidence rate of PPH,and PPH might increase the mid-term all-cause mortality.
作者 张亚楠 庞雅湘 陈天磊 谷国强 谢瑞芹 崔炜 ZHANG Ya-nan;PANG YA-xiang;CHEN Tian-lei;GU Guo-qiang;XIE Rui-qing;CUI Wei(The First Department of Cardiology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Experimental Center of Clinical College,Hebei Medical University,Shijiazhuang 050031,China;The Sixth Department of Cardiology,Hebei General Hospital,Shijiazhaung 050051,China)
出处 《河北医科大学学报》 CAS 2019年第2期144-148,共5页 Journal of Hebei Medical University
基金 河北省医学科学研究重点课题(20170570).
关键词 冠心病 餐后低血压 肥胖 超重 coronary disease postprandial hypotension obesity overweight
作者简介 张亚楠(1980-),女,河北石家庄人,河北医科大学第二医院主治医师,医学硕士,从事心血管内科疾病诊治研究;通信作者:崔炜。E-mail:cuiwei@medmail.com.cn
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