基础医学与临床 ›› 2021, Vol. 41 ›› Issue (1): 97-99.

• 临床研究 • 上一篇    下一篇

惊恐发作所致阵发性高血压患者的临床特点

冯玲1,2, 崔云英1, 马晓森1, 王芬1, 王慧萍1, 童安莉1*, 李玉秀1   

  1. 1.中国医学科学院 北京协和医学院 北京协和医院 内分泌科 国家卫生健康委员会内分泌重点实验室, 北京 100730;
    2.内蒙古医科大学第三附属医院(包头钢铁医院) 内分泌科, 内蒙古 包头 014010
  • 收稿日期:2019-10-24 修回日期:2020-03-28 出版日期:2021-01-05 发布日期:2020-12-30
  • 通讯作者: *tonganli@hotmail.com

Clinical characteristics of patients with paroxysmal hypertension caused by panic attack

FENG Ling1,2, CUI Yun-ying1, MA Xiao-sen1, WANG Fen1, WANG Hui-ping1, TONG An-li1*, LI Yu-xiu1   

  1. 1. Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission of the People's Republic of China, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730;
    2. Department of Endocrinology, the Third Affiliated Hospital of Inner Mongolia Medical University (Baotou Steel Hospital), Baotou 014010, China
  • Received:2019-10-24 Revised:2020-03-28 Online:2021-01-05 Published:2020-12-30
  • Contact: *tonganli@hotmail.com

摘要: 目的 探讨惊恐发作导致的阵发性高血压的临床特点。方法 回顾性分析在北京协和医院诊治的24例惊恐发作患者的临床资料。结果 19例患者在平时高血压基础上呈阵发性高血压加重,患者平时服降压药治疗,血压控制在(136±12)/(84±9)mmHg,惊恐发作时血压升至(181±13)/(105±15)mmHg。5例患者平时血压正常,(125±10)/(76±6)mmHg,发作时血压(175±26)/(92±14)mmHg。发作持续时间从10余秒到6个小时不等,发作不规律,数年1次~1 d数次,54%的患者有精神情绪改变等发作诱因。惊恐发作时伴心悸/心慌、头晕、胸闷比例分别为92%、75%和33%。检测患者24 h尿儿茶酚胺均正常。结论 惊恐发作时患者血压可明显升高,常见伴随症状为心悸/心慌、头晕、胸闷和多存在精神情绪改变等发作诱因。临床上需要进行必要的生化和激素检测以除外嗜铬细胞瘤等器质性疾病。

关键词: 阵发性血压升高, 惊恐发作, 临床特点

Abstract: Objective To explore the clinical characteristics of patients with paroxysmal hypertension caused by panic attacks. Methods The clinical data of 24 patients with panic attack treated in Peking Union Medical College Hospital were retrospectively analyzed. Results Nineteen patients presented paroxysmal aggravation of hypertension. Blood pressure of the patients was usually controlled at (136±12/84±9)mmHg with antihypertensive therapy, and rose to (181±13)/(105±15)mmHg during panic attack. The other 5 patients were usually normotensive with average blood pressure (125±10)/(76±6)mmHg, and their blood pressure rose to (175±26)/(92±14)mmHg at panic attack. The surge of blood pressure last from more than ten seconds to six hours. And the attacks were irregular with the frequency ranging from once a few years to several times a day. The attack was triggered by psycho-emotional changes in 54% patients. The proportions of palpitation/panic, dizziness and chest tightness were 92%, 75% and 33% respectively. 24 hours urine catecholamines were normal in all patients. Conclusions Blood pressure of the patients may significantly enhance during panic attacks, mostly accompanying with palpitation/panic, dizziness, chest tightness. The attack may be triggered by psycho-emotional changes. Necessary biochemical tests are needed to exclude other diseases such as pheochromocytoma.

Key words: paroxysmal elevation of blood pressure, panic attack, clinical characteristics

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