立、坐、卧三体位对高血压患者血压值的影响

The influence of body positions on blood pressure in hypertensive patients

  • 摘要: 目的探讨不同体位对高血压患者血压值的影响。方法连续选取在住院的高血压患者334例(男202例,女132例)进入试验。受试者依次采取立、坐、卧三体位,每种体位均保持2 h,在2 h末使用台式水银血压计在该体位手动测量血压;试验期间通过臂式电子动态血压仪测量电子血压值1次/15 min。记录并分析各体位2 h末的电子血压值和台式水银血压值。结果 2 h末臂式电子动态血压仪测量的收缩压随体位无明显变化,而舒张压变化有统计学意义:立位较卧位高(7.3±0.8)mm Hg,坐位较卧位高(7.2±0.7)mm Hg。立位与坐位间差异无统计学意义。2 h末台式水银血压计的测量值随体位改变均有变化:收缩压在立位较卧位低(6.0±1.0)较坐位低(3.3±0.8),坐位较卧位低(2.6±0.9)mm Hg;舒张压在立位较卧位高(1.8±0.8),坐位较卧位高(2.4±0.7)mm Hg。在立位,臂式电子动态血压仪较台式水银血压计测量的收缩压高(8.6±15.0)mm Hg(P<0.05),舒张压高(4.4±11.9)mm Hg(P<0.05);在坐位,臂式电子动态血压仪较台式水银血压计测量的收缩压高(7.3±16.4)mm Hg(P<0.05),舒张压高(3.7±12.2)mm Hg(P<0.05);在卧位,臂式电子动态血压仪较台式水银血压计测量的收缩压高(2.9±15.2)mm Hg(P<0.05),而舒张压之间无差异。通过多元线性回归分析发现,三体位收缩压差值与高血压病程、空腹血糖和性别有关;舒张压差值与年龄和胆固醇有关。结论体位对高血压患者血压测量值有影响,不同体位下臂式动态电子血压仪测量的血压值均高于台式水银血压计测量的血压值。三体位收缩压和舒张压差值的影响因素不同。

     

    Abstract: Objective To study the body position-induced changes of blood pressure(BP) in hypertensive patients and possible influencing factors.Methods With a standard mercury sphygmomanometer(CBP) and ambulatory blood pressure monitoring(ABP),standing,sitting and supine BP measurements were carried out in turns in 334 hospitalized hypertensive patients when they kept the above body positions for 2 hours respectively.During the testing,BP was taken by ABP per 15 min,while CBP measured at the end of each posture period.Clinical characteristics and medication,such as the subjects’ body weight,height,bilateralis pulses and blood glucose levels,were also observed.Results Both systolic and diastolic blood pressures(SBP and DBP respectively) were significantly different among standing,sitting and supine positions except ABP-SBP.CBP-SBP in supine position was higher compared to that in standing and sitting position by(6.0±1.0)/(2.6±0.9) mm Hg respectively,P<0.05,but CBP-DBP in supine position was lower than in standing and sitting position by(1.8±0.8)/(2.4±0.7)mm Hg respectively,P<0.05;ABP-DBP were significantly lower in supine position than in standing and sitting position by(7.3±0.8)/(7.2±0.7)mm Hg respectively,P<0.05.Except supine DBP,ABP-BP was significantly higher than CBP-BP in standing,sitting and supine positions by(8.6±15.0)/(4.4±11.9)mm Hg,(7.3±16.4)/(3.7±12.2)mm Hg,and(2.9±15.2)mm Hg respectively,P<0.05.Multivariate regression analysis showed that the duration of hypertension,gender and fasting plasma glucose(FPG) were independent factors of SBP variation(P<0.05),while age and cholesterol were independent predictors for DBP variation(P<0.05).Conclusion The change of body position contributes to variations of blood pressure in hypertensive patients.Blood pressure levelsare significantly different in each position.Such factors as the course of hypertension,age,FBG and cholesterol can result in blood pressure variations among standing,sitting and supine positions.

     

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