CAJ | 학술논문

目的：通过对青年与老年原发性高血压的血压水平、血压分类、危险因素及靶器官损害和并存临床情况的比较，探讨青年高血压病的临床特点，为青年高血压病的临床防治提供参考依据。方法随机选择2008年1月~2008年12月在西安交通大学医学院第一附属医院住院的原发性高血压病患者314例，按年龄分为青年组172例（≤45岁）和老年组142例（≤60岁＜75岁）进行病例对照研究，两组患者具有可比性。比较两组间发病的一般情况、实验室检查、靶器官损害及并存临床情况的特点。结果（1）血压水平比较，收缩压青年组低于老年组，舒张压青年组高于老年组；（2）男性、高血压病家族史、吸烟、饮酒、肥胖在青年组中的发生率明显高于老年组；（3）青年组血钠含量较老年组低，血钙含量较老年组高；青年组中TG、ApoB显著高于老年组、HDL-C、ApoA-I、ApoA-I/ApoB则显著低于老年组；两组HOMA-IR水平比较，（2.77±2.80）uU/Lvs（1.80±1.49uU/L）。结论（1）青年高血压病以舒张压升高为主，脉压差较小，患病年龄较短，血压升高程度较轻。青年高血压病患者中，1、2级高血压及单纯舒张期高血压较老年组多见。（2）家族史、肥胖、饮酒、吸烟是青年高血压病患者的主要危险因素。（3）青年高血压病患者合并脂代谢、胰岛素抵抗、糖代谢等代谢性问题的比例较大。
목적：통과대청년여노년원발성고혈압적혈압수평、혈압분류、위험인소급파기관손해화병존림상정황적비교，탐토청년고혈압병적림상특점，위청년고혈압병적림상방치제공삼고의거。방법수궤선택2008년1월~2008년12월재서안교통대학의학원제일부속의원주원적원발성고혈압병환자314례，안년령분위청년조172례（≤45세）화노년조142례（≤60세＜75세）진행병례대조연구，량조환자구유가비성。비교량조간발병적일반정황、실험실검사、파기관손해급병존림상정황적특점。결과（1）혈압수평비교，수축압청년조저우노년조，서장압청년조고우노년조；（2）남성、고혈압병가족사、흡연、음주、비반재청년조중적발생솔명현고우노년조；（3）청년조혈납함량교노년조저，혈개함량교노년조고；청년조중TG、ApoB현저고우노년조、HDL-C、ApoA-I、ApoA-I/ApoB칙현저저우노년조；량조HOMA-IR수평비교，（2.77±2.80）uU/Lvs（1.80±1.49uU/L）。결론（1）청년고혈압병이서장압승고위주，맥압차교소，환병년령교단，혈압승고정도교경。청년고혈압병환자중，1、2급고혈압급단순서장기고혈압교노년조다견。（2）가족사、비반、음주、흡연시청년고혈압병환자적주요위험인소。（3）청년고혈압병환자합병지대사、이도소저항、당대사등대사성문제적비례교대。
Objective To study and research the differences of hypertension between the youth and the old, which related to the risk factors and the clinical characteristics, in order to improve the precaution and treatment of the youth hypertension. Methods A case-control study was conducted involving 172 young (below 45 years old) and 142 elderly (between 60 to 75 years old) patients with clinical diagnosis of essential hypertension. It is comparable between the two groups. The differences in the risk factors, the level of the ion in the blood serum and clinical characteristics were analyzed between the two groups. Results In the comparison of the blood pressure level, the elderly group had higher systolic blood pressure and the youth group had higher diastolic blood pressure. Compared with the elderly patients, the risk factors of smoking, drinking and positive family history was more frequently found among the young patients. The level of sodium ion is lower, while the calcium ion is higher in the young patients than in the elderly patients. The levels of triglyceride(TG) and apolipoprotein B(ApoB) were significantly higher, while high-density lipoprotein cholesterol(HDL-C), and apolipoprotein A-I(ApoA-I)lower in the young patients than in the elderly patients. HOMA-IR is higher in the youth group than in the old group. And the fasting blood glucose in the two groups has no obviously difference. Conclusion The characteristics of hypertension in the young patients are apparent. The diastolic blood pressure rises more obviously. The pulse pressure is small. And the age with disease in the young patients is short. The stage 1, stage 2 hypertension and IDH are common in young patients. Smoking, drinking, metabolic disorders and positive family history are the major risk factors for hypertension among individuals below the age of forty-five. The levels of triglyceride(TG) and apolipoprotein B(ApoB) were significantly higher in the youth group. And the HOMA-IR is higher in the youth group. So it illuminates that the youth group may accompany metabolic syndrome. So the precaution and treatment of the hypertension is different in different age levels.