中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
2期
138-141
,共4页
刘蔚%李红云%李莹莹%孙可竹
劉蔚%李紅雲%李瑩瑩%孫可竹
류위%리홍운%리형형%손가죽
高血压%危险因素
高血壓%危險因素
고혈압%위험인소
Hypertension%Risk factors
目的 观察80岁以上老年高血压住院患者的临床特点和相关危险因素. 方法 选择2003年2月至2012年5月北京医院老年科和心内科住院的80岁以上的老年高血压患者336例,收集相关病史和临床资料,包括家族史、身高、体质量、诊室血压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、肌酐、尿素、尿酸、尿蛋白等. 结果 80岁以上老年高血压患者以收缩压升高为主,脉压大,肾小球滤过率下降.336例患者中,脂代谢异常190例(56.5％),心房颤动45例(13.4％),慢性心功能不全66例(19.6％),微量蛋白尿53例(15.8％),冠心病139例(41.4％),脑血管病81例(24.1％).男性(240例)和女性(96例)左心室肥厚分别为25例(10.4％)和22例(22.9％)；患糖尿病分别是111例(46.3％)和27例(28.1％),差异有统计学意义(x2值分别为8.91、9.38,均P＜0.01).311例(92.6％)使用降压药治疗.使用利尿剂37例(11.9％),钙拮抗剂为182例(58.5％),血管紧张素受体拮抗剂89例(28.6％),血管紧张素转换酶抑制剂为68例(21.9％),β受体阻断剂为92例(29.6％),α受体阻断剂为31例(10.0％).96例(30.9％)患者联合使用了他汀类调脂药,151例(48.6％)使用了抗血小板类药物.109例(35.0％)患者使用1种降压药,202例(65.0％)使用2种以上降压药. 结论 住院80岁以上老年高血压患者伴随多种危险因素和靶器官损害,多数患者使用两种或两种以上降压药治疗.
目的 觀察80歲以上老年高血壓住院患者的臨床特點和相關危險因素. 方法 選擇2003年2月至2012年5月北京醫院老年科和心內科住院的80歲以上的老年高血壓患者336例,收集相關病史和臨床資料,包括傢族史、身高、體質量、診室血壓、空腹血糖、總膽固醇、三酰甘油、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、肌酐、尿素、尿痠、尿蛋白等. 結果 80歲以上老年高血壓患者以收縮壓升高為主,脈壓大,腎小毬濾過率下降.336例患者中,脂代謝異常190例(56.5％),心房顫動45例(13.4％),慢性心功能不全66例(19.6％),微量蛋白尿53例(15.8％),冠心病139例(41.4％),腦血管病81例(24.1％).男性(240例)和女性(96例)左心室肥厚分彆為25例(10.4％)和22例(22.9％)；患糖尿病分彆是111例(46.3％)和27例(28.1％),差異有統計學意義(x2值分彆為8.91、9.38,均P＜0.01).311例(92.6％)使用降壓藥治療.使用利尿劑37例(11.9％),鈣拮抗劑為182例(58.5％),血管緊張素受體拮抗劑89例(28.6％),血管緊張素轉換酶抑製劑為68例(21.9％),β受體阻斷劑為92例(29.6％),α受體阻斷劑為31例(10.0％).96例(30.9％)患者聯閤使用瞭他汀類調脂藥,151例(48.6％)使用瞭抗血小闆類藥物.109例(35.0％)患者使用1種降壓藥,202例(65.0％)使用2種以上降壓藥. 結論 住院80歲以上老年高血壓患者伴隨多種危險因素和靶器官損害,多數患者使用兩種或兩種以上降壓藥治療.
목적 관찰80세이상노년고혈압주원환자적림상특점화상관위험인소. 방법 선택2003년2월지2012년5월북경의원노년과화심내과주원적80세이상적노년고혈압환자336례,수집상관병사화림상자료,포괄가족사、신고、체질량、진실혈압、공복혈당、총담고순、삼선감유、고밀도지단백담고순、저밀도지단백담고순、기항、뇨소、뇨산、뇨단백등. 결과 80세이상노년고혈압환자이수축압승고위주,맥압대,신소구려과솔하강.336례환자중,지대사이상190례(56.5％),심방전동45례(13.4％),만성심공능불전66례(19.6％),미량단백뇨53례(15.8％),관심병139례(41.4％),뇌혈관병81례(24.1％).남성(240례)화녀성(96례)좌심실비후분별위25례(10.4％)화22례(22.9％)；환당뇨병분별시111례(46.3％)화27례(28.1％),차이유통계학의의(x2치분별위8.91、9.38,균P＜0.01).311례(92.6％)사용강압약치료.사용이뇨제37례(11.9％),개길항제위182례(58.5％),혈관긴장소수체길항제89례(28.6％),혈관긴장소전환매억제제위68례(21.9％),β수체조단제위92례(29.6％),α수체조단제위31례(10.0％).96례(30.9％)환자연합사용료타정류조지약,151례(48.6％)사용료항혈소판류약물.109례(35.0％)환자사용1충강압약,202례(65.0％)사용2충이상강압약. 결론 주원80세이상노년고혈압환자반수다충위험인소화파기관손해,다수환자사용량충혹량충이상강압약치료.
Objective To study the clinical characteristics and relative risk factors of hypertensive inpatients aged over 80 years.Methods From February 2003 to May 2012,336 hypertensive inpatients aged over 80 years were enrolled in the study.Medical history and family history including height,weight,blood pressure,fasting glucose,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,creatinine,urea nitrogen,uric acid and urine protein levels were recorded and analyzed statistically.Results The elderly hypertensive inpatients over 80 years old had systolic hypertension with widening pulse pressure and the decline in glomerular filtration rate.The incidence of dyslipidemia,atrial fibrillation,microalbuminuria,coronary heart disease,cerebrovascular disease were 56.5 ％ (190/336),13.4 ％(45/336),15.8％ (53/336),41.4％ (139/336) and 24.1％ (81/336),respectively.Whereas there was no significant sex difference (P＞0.05).A significant difference was found in the incidence of left vetricular hypertrophy between males (10.4％,25/240) and females (22.9％,22/96) (x2 =8.91,P＜0.01).The prevalence of diabetes in males (46.3％,111/240) was significantly higher than in females (28.1％,27/96) (x2=9.38,P＜0.01).From the 336 patients in the study,311 (92.6％)were treated by antihypertensive agents.The antihypertensive drugs included diuretics (37 patients,11.9％),calcium channel blocker (182 patients,58.5％),angiotensin receptor antagonists (89 patients,28.6％),angiotensin converting enzyme inhibitors (68 patients,21.9％),β-blockers (92 patients,29.6％),α-blockers (31 patients,10.0％),either alone (109 patients,35.0％) or in combination (202 patients,65.0％).96 (30.9％) patients were medically treated for dyslipidemia (drugs including statins).151 (48.6％) patients were treated with antiplatelet drugs.Conclusions The elderly hypertensive inpatients,over 80 years old,were accompanied by multiple risk factors and target organ damage,and most of them was treated with antihypertensive agents in combination.
