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目的:了解养老机构老年人在不同衰弱状态下，卧立位变化时各体位的血压、心率差异，并探究直立性低血压对衰弱的预测作用，为养老机构护理提供参考。方法:2020年4—8月选取214例杭州金色年华金家岭退休生活中心、杭州博养养老服务有限公司、杭州朗和国际医养中心3家养老机构老年人，使用一般资料调查表、Frail量表、Barthel指数评定量表对老年人进行调查，使用上臂式电子血压计测量老年人卧位、立位1 min和立位3 min的心率和血压，并进行比较。结果:养老机构老年人衰弱合并直立性低血压的发生率为26.64%（57/214）；无衰弱、衰弱前期、衰弱老年人直立性低血压的发生率逐渐升高，分别为14.29%（5/35）、20.00%（12/60）、47.90%（57/119）。衰弱老年人和无衰弱老年人在卧位心率、卧位收缩压、立位1 min收缩压差值和立位3 min收缩压差值上比较差异有统计学意义（n t=2.16、3.25，n H=3.16、4.08，均n P<0.05）；衰弱前期老年人和无衰弱老年人在卧位收缩压上比较差异有统计学意义（n t=2.02，n P<0.05）；衰弱老年人和衰弱前期老年人在立位 3 min收缩压差值、立位3 min舒张压差值上比较差异有统计学意义（n H=3.13、2.44，均n P<0.05）。有序Logistic回归分析显示，直立性低血压是衰弱的危险因素（n OR=2.425，95% n CI 1.133 ~ 4.988，n P<0.05）。n 结论:患有直立性低血压的养老机构老年人更容易出现衰弱，而衰弱也会减弱直立姿势血压调节的能力，护理人员应重视衰弱和直立性低血压的评估、健康教育和干预，防止体位变化时意外的发生。“,”Objective:To understand the predictive effect of orthostatic hypotension on frailty in nursing homes, and the effect of frailty on heart rate and blood pressure in supine positionand orthostatic position.Methods:A total of 214 elderly cases in three nursing homes (the Golden Years of Jinjialing Retirement Life Center, Hangzhou Boyang Pension Service Co., Ltd, Hangzhou Langhe International Medical Care Center) were interviewed by the general information questionnaire, the Frail Scale and Barthel Index. Systolic blood pressure, diastolic blood pressure, and heart rate were measured by electronic sphygmomanometer in supine position and orthostatic position of 1 and 3 minutes.Results:The incidence of frailty combined with orthostatic hypotension was 26.64%(57/214) in the elderly in nursing homes. The incidence of orthostatic hypotension in the robust elderly, pre-frailty and frailty gradually increased, 14.29%(5/35), 20.00%(12/60), 47.90%(57/119). The differences of heart rate and systolic blood pressure in supine position between the elderly with and without frailty were significant (n t=2.16, 3.25, n P<0.05), the differences of systolic pressure difference in orthostatic position of 1 and 3 minutes between the elderly with and without frailty were significant (n H=3.16, 4.08, n P<0.01). There was significant difference in systolic pressure between the prefrail elderly and the elderly without frailty in lying position (n t=2.02, n P<0.05). The differences of systolic and diastolic pressure differences in orthostatic position of 3 minutes between the frail elderly and pre-frail elderly were significant (n H=3.13,2.44, n P<0.05). Ordered Logistic regression analysis showed that orthostatic hypotension was a risk factor for frailty (n OR=2.425, 95% n CI were 1.133-4.988, n P<0.05).n Conclusions:Elderly adults with orthostatic hypotension in nursing homes have a higher prevalence of frailty. Frailty also impairs blood pressure regulation during postural changes. Nurses should attach importance to the assessment, education and intervention of frailty and orthostatic hypotension.