CAJ | 학술논문

目的：观察老年高血压及高血压合并良性前列腺增生症患者的血浆D-二聚体含量变化，与单纯患良性前列腺增生症的患者及正常老年人比较。同时观察各组患者4年中的死亡人数，了解血浆D-二聚体变化在老年高血压及其合并前列腺增生症患者中的意义及与死亡率的关系。方法选择2009年1月至2012年12月4年期间在武汉大学中南医院住院的老年高血压患者，根据其是否合并良性前列腺增生症分为老年高血压组（80例）及高血压合并前列腺增生（合并症）组（77例），同期选择正常老年人（50例）及单纯良性前列腺增生症患者（50例）作为对照。比较4组血浆D-二聚体含量的变化。同时观察4年期间各组死亡人数及其与血浆D-二聚体含量的关系。结果（1）高血压组及合并症组血浆D-二聚体水平明显高于正常组，而合并症组血浆D-二聚体水平又明显高于高血压组、单纯良性前列腺增生组及正常组。（2）4年期间共死亡16例，全部集中在高血压组及合并症组。而合并症组死亡人数明显高于高血压组。（3）无论高血压组或合并症组的死亡患者，血浆D-二聚体水平均明显高于同组平均值。且死亡患者在死亡前1～3d血浆D-二聚体水平增加更加明显。结论高血压患者血浆D-二聚体水平较正常对照组明显增高，而当其合并良性前列腺增生时，血浆D-二聚体水平增高更加明显。D-二聚体水平的增高与患者的死亡率密切相关。提示我们对于高血压患者，尤其是对合并前列腺增生症的患者，应关注血浆D-二聚体的水平，注重保护患者的血管内皮功能，从而达到减少患者死亡率及提高生活质量的目的。
목적：관찰노년고혈압급고혈압합병량성전렬선증생증환자적혈장D-이취체함량변화，여단순환량성전렬선증생증적환자급정상노년인비교。동시관찰각조환자4년중적사망인수，료해혈장D-이취체변화재노년고혈압급기합병전렬선증생증환자중적의의급여사망솔적관계。방법선택2009년1월지2012년12월4년기간재무한대학중남의원주원적노년고혈압환자，근거기시부합병량성전렬선증생증분위노년고혈압조（80례）급고혈압합병전렬선증생（합병증）조（77례），동기선택정상노년인（50례）급단순량성전렬선증생증환자（50례）작위대조。비교4조혈장D-이취체함량적변화。동시관찰4년기간각조사망인수급기여혈장D-이취체함량적관계。결과（1）고혈압조급합병증조혈장D-이취체수평명현고우정상조，이합병증조혈장D-이취체수평우명현고우고혈압조、단순량성전렬선증생조급정상조。（2）4년기간공사망16례，전부집중재고혈압조급합병증조。이합병증조사망인수명현고우고혈압조。（3）무론고혈압조혹합병증조적사망환자，혈장D-이취체수평균명현고우동조평균치。차사망환자재사망전1～3d혈장D-이취체수평증가경가명현。결론고혈압환자혈장D-이취체수평교정상대조조명현증고，이당기합병량성전렬선증생시，혈장D-이취체수평증고경가명현。D-이취체수평적증고여환자적사망솔밀절상관。제시아문대우고혈압환자，우기시대합병전렬선증생증적환자，응관주혈장D-이취체적수평，주중보호환자적혈관내피공능，종이체도감소환자사망솔급제고생활질량적목적。
ObjectiveTo evaluate the changes of serumlevel ofD-dimer intheelderly essential hypertensive patientswith or withoutcoexisting benign prostatic hyperplasia (BPH) andcompare the resultswiththose ofthe healthy elderly people and the patientswithsimple BPH in order to investigate the clinical significance of serumD-dimer intheelderly essential hypertensive patientswithcoexistingBPHand its relationship with mortality.MethodsA total of157 elderly patients with primary hypertension admittedinour hospital from January 2009to December 2012 wererecruited in this study. They weredivided into2 groups according to whether coexistingBPH, that is, simple hypertension group(group H,n=80) and coexisting group(group C,n=77).Another50 healthy elderlymen(group N) and 50 elderly patients ofsimple BPH(group P)hospitalized during the same period servedas control groups respectively. The serumlevel ofD-dimerwere measured andcomparedinallthe 4groups. In the meanwhile, the number of death wascalculated in the cohortduring the 4 years’ follow-up andthe relationship between themortality andserum D-dimerwas analyzed.ResultsThe serumlevels ofD-dimer were higher in groups H and C thaningroup N,while, that in group C wasthe highestamong all groups.During the 4 years’ follow-up, there were totally 16 patients died in the cohort, and all of themwerefrom group H and group C, with more in group C than in group H.For all these died patients, theirserum D-dimerwasobviously higher thanthe patientsfrom the same group. What’s more, the increase even became more severely in 1 to 3d before death.ConclusionThe serum D-dimeris increased intheelderly essential hypertensive patients than in normalold men, and it ismore higherin the elderly hypertensive patients with coexistingBPH.Its increaseis closelyrelated to mortality. Our results suggest that we payattention to the serum D-dimer for theelderly hypertensive patients, especially with coexistingBPH, and focus on the protection of vascular endothelial function, thusto decreasethemortality and improvethequality of life.