摘要
目的总结分析表现为晕厥的餐后低血压的临床特点,并结合文献复习,以提高对该病的认识。方法回顾性分析2015年1月至2019年12月首都医科大学附属北京友谊医院收治的6例表现为晕厥的餐后低血压患者的临床特征,辅助检查、血压测定结果以及治疗和预后情况。结果6例患者均为老年人,年龄65~85岁,年龄(73.1±7.5)岁;其中男性4例,女性2例。其中4例患者分别合并高血压、2型糖尿病和帕金森病。6例患者的晕厥均发生在餐后2 h内,其中5例患者伴有神经系统缺血症状,2例患者伴有心血管系统缺血症状。血压监测显示,餐前与餐后2 h内收缩压最大差值波动在20~38 mmHg,平均(29.0±6.7)mmHg,日间收缩压和舒张压的变异均高于夜间,2例患者伴有体位性低血压。经过针对基础疾病的治疗、降压药物的调整,以及非药物治疗和药物治疗后,餐前与餐后2 h内收缩压最大差值波动在8~15 mmHg,平均(12.2±2.8)mmHg,较治疗前明显改善。其中4例患者未再出现晕厥。2例患者间断出现晕厥,但频率明显减少,为1~2次/年。结论餐后低血压所致晕厥常见于老年人,但往往因为对此病的认识不足而被忽视。患者多合并有心脑血管缺血的症状,有较高的风险性。早期诊断,及时治疗,临床疗效较好。提高对餐后低血压所致晕厥的识别,有利于明确不明原因晕厥的诊断,降低患者的心脑血管疾病风险,改善患者的预后。
Objective To investigate the clinical features of postprandial hypotension-related syncope,and review the literature to improve the understanding of this disease.Methods The clinical features,examination results,blood pressure,treatment and prognosis of 6 patients with postprandial hypotension-related syncope in Beijing Friendship Hospital,Capital Medical University from January 2015 to December 2019 were retrospective analyzed.Results All 6 patients were elderly people,aged from 65 to 85 years,with an average age of(73.1±7.5)years,4 males and 2 females.4 patients were accompanied with hypertension,diabetes mellitus or Parkinson's disease.Syncope occurred within 2 hours after meals in all 6 patients.5 patients presented with neurological ischemia symptoms,and 2 patients with cardiovascular ischemia symptoms.Blood pressure monitoring showed the maximum systolic pressure variation between preprandial and postprandial was 20-38 mmHg,with an averaged of(29.0±6.7)mmHg,meanwhile both the daytime systolic pressure variation and diastolic pressure variation were higher than those of the nighttime.2 patients were accompanied with orthostatic hypotension.After the treatment of the concomitant diseases and modification of antihypertensive medications,with the non-pharmacological and pharmacological treatment,the systolic pressure variation was reduced to 8-15 mmHg,with an averaged of(12.2±2.8)mmHg.No more syncope occurred in 4 patients.And syncope occurred in 2 patients with a significantly reduced frequency of 1-2 times/year.Conclusion Postprandial hypotension-related syncope is common in elderly people,but it is often overlooked because of insufficient understanding of the disease.It was accompanied with cardio-cerebrovascular ischemia symptoms,so the patients were in the high risk.Early diagnosis and timely treatment lead to better prognosis.Improving the recognition of syncope caused by postprandial hypotension is conducive to improving the diagnosis of syncope of unknown reason,reducing the risk of cardio-cerebrovascular diseases,and improving the prognosis of patients.
作者
张丽燕
王淑辉
赵明霞
脱厚珍
张拥波
ZHANG Li-yan;WANG Shu-hui;ZHAO Ming-xia(Department of Neurology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2020年第14期1563-1567,共5页
Journal of Clinical and Experimental Medicine
基金
首都医科大学附属北京友谊医院院内启动基金(编号:yyqdkt2018-30)。
关键词
晕厥
餐后低血压
临床特征
Syncope
Postprandial hypotension
Clinical features
