首页> 中文期刊>国际病理科学与临床杂志 >灾区高龄老年高血压患者抗焦虑的治疗疗效

灾区高龄老年高血压患者抗焦虑的治疗疗效

     

摘要

目的:探讨灾区高龄老年高血压患者血压波动水平变化及应用抗焦虑治疗对其血压的影响.方法:选取救灾期间灾区单纯高龄老年原发性高血压患者46例,采集其基本资料;并进行汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)评分,同时比较24 h动态血压监测及脉搏波传导速度(pulse wave velocity,PWV);随机分为2组:抗焦虑组23例,给予常规内科降压治疗的同时增加抗焦虑药物及心理疏导治疗;对照组23例,单纯给予常规内科降压药物治疗,治疗随访8周后比较2组HAMA分值、血压变异性[晨峰现象(morning blood pressure surge,MBPS)、血压变异(blood pressure variability,BPV)]及血管僵硬度[脉压指数(pulse pressure index,PPI)、动态动脉硬化指数(ambulatory arterial stiffness index,AASI)、中心动脉压(central aortic pressure,CAP)及PWV]变化情况并分析疗效.结果:46例老年高血压患者在洪灾及重建过程中均出现了不同程度的焦虑情绪,且血压随之波动明显.治疗8周后两组患者HAMA分值、血压变异性(MBPS、短时BPV)及PPI较治疗前改善均有统计学意义(P<0.05);但抗焦虑组患者改善情况明显优于对照组(P<0.05);两组患者血管僵硬度指标中CAP、AASI、PWV较治疗前改善均不明显,差异无统计学意义(P>0.05).结论:灾害及灾后重建易在高龄老年人群中引起不同程度的焦虑情绪,导致高龄老年高血压患者血压水平处于应激状态.对经历灾难及灾后重建的高龄老年高血压患者在常规内科降压治疗的同时,给予积极的药物抗焦虑治疗及心理疏导措施,能有效提高临床血压控制疗效.%Objective:To investigate the changes of blood pressure fluctuation in elderly patients with hypertension and the effect of anxiolytic therapy on blood pressure.Methods:The basic information was collected in 46 elderly patients with primary hypertension in the disaster area during the period of flood relief;and Hamilton Anxiety Scale (HAMA),ambulatory blood pressure monitoring and pulse wave velocity (PWV) were measured at the same time.The patients were randomly divided into two groups:anesthesia group (23 cases),which received conventional medical antihypertensive therapy while increasing the anxiolytic drugs and psychological counseling treatment;control group (23 cases) were simply given conventional medical antihypertensive drugs.After 8 weeks of treatment,HAMA score,blood pressure variability [morning peak phenomenon (MBPS),blood pressure variability (BPV)] and vascular stiffness [pulse pressure index (PPI),ambulatory arterial stiffness index (AASI),central arterial pressure (CAP) and PWV] changes were measured and compared between the two groups and analyze the effect of each treatment.Results:Forty-six cases of elderly hypertensive patients in the flood and reconstruction process have appeared in varying degrees of anxiety,and blood pressure fluctuated significantly.After 8 weeks of treatment,HAMA score,blood pressure variability (MBPS,short-term BPV) and PPI were significantly higher than those before treatment (P<0.05).But the improvement of the patients in the anxiolytic group was better than that in the control group (P<0.05).There was no significant difference in CAP,AASI and PWV between the two groups in the vascular stiffness index (P>0.05).Conclusion:Flooding and post-disaster reconstruction can easily cause different levels of anxiety in the elderly population,which may lead to the state of stress in elderly hypertensive patients.The elderly patients with hypertension who underwent flood and post-disaster reconstruction were treated with conventional antihypertensive therapy,as well as with anti-anxiety treatment and psychological counseling,which could effectively improve the clinical control of blood pressure.

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