摘要目的 探讨老年高血压患者体位性低血压和左心室结构与功能间的关系. 方法 选取2013年7月至2015年6月期间我院诊治的101例老年高血压患者,全部患者经过立卧位血压测量后,分为非体位性低血压与体位性低血压两组.接受超声心动图检查,并对左心室质量指数准确计算. 结果 与非体位性低血压相比,体位性低血压患者的左心室舒张内径、左心窒后壁厚度、室间隔厚度、左室质量指数明显上升[(48.13±5.54)mm和(52.45±1.48)mm、(10.08±1.87)mm和(11.29±1.98)mm、(10.18±1.88)mm和(11.61±1.66)mm,(114.59±22.72)g/m2和(131.98±23.43)g/m2,t=4.386、2.985、4.397、8.672,均P＜0.05];左心室射血分数与二尖瓣舒张早期/晚期血流峰值有所下降[(60.81±4.73)％和(53.60±2.58)％、(0.93±0.23)％和(0.76±0.26)％,t=4.298、3.654,均P＜0.05]. 结论 老年高血压患者体位性低血压和左心室结构与功能存在联系,不仅需要对血压有效控制,还应该重点控制体位性低血压.

abstractsObjectives To explore the relationship of orthostatic hypotension in elderly hypertensive patients with left ventricular structure and function.Methods 101 cases of elderly patients with hypertension were selected from July 2013 to June 2015.After blood pressure measurement in vertical and decubitus position,all patients were divided into non-orthostatic hypotension and orthostatic hypotension groups,received the echocardiography and the accurate calculation of left ventricular mass index.Results Compared with non-orthostatic hypotension,orthostatic hypotension in patients with left ventricular diastolic diameter,left ventricular posterior wall thinckness and interventricular septum thickness.Left ventricular mass index significantly increased(48.13±5.54)mm vs.(52.45 ± 1.48)mm in left ventricular diastolic diameter,(10.08± 1.87)mm vs.(11.29± 1.98)mm in left ventricular posterior wall thickness,(10.18± 1.88)mm vs.(11.61±1.66) mm in interventricular septum thickness,and (114.59 ± 22.72) g/m2 vs.(131.98 ± 23.43)g/m2 [t=4.386、2.985、4.397、8.672,in left ventricular mass index(BMI),all P＜0.05].Left heart ventricular ejection fraction and mitral peak early/late diastolic blood flow decreased [(60.81 ± 4.73)vs.(53.60±2.58)and(0.93±0.23)vs(0.76±0.26)t=4.298、3.654,all P＜0.05].Conclusions There is relationship of orthostatic hypotension with left ventricular structure and function in elderly hypertension patients,and it is essential not only to control blood pressure effectively,but also to focus on controlling orthostatic hypotension.