CAJ | 학술논문

目的分析评估老年住院高血压患者的病因构成及靶器官损害情况. 方法分析高血压科诊断明确的1 270例(年龄60～91岁)住院患者的病因分类及其合并靶器官损害的情况和特点. 结果老年住院高血压患者中原发性高血压1 090例(85.8％),继发性高血压180例(14.2％);在继发性高血压中肾血管性高血压所占比例(67.8％)最高,其次为原发性醛固酮增多症(23.3％);在1 090例原发性高血压患者中,有88.3％的患者存在靶器官损害或其他临床疾病.靶器官损害中颈动脉内膜增厚和左心室肥厚的检出率分别为66.6％和24.0％.在靶器官疾病中脑卒中、冠心病和慢性肾功能不全检出率分别为30.2％、26.7％和10.5％;原发性高血压患者的脑卒中、冠心病、慢性肾功能不全的检出率随年龄增加呈上升趋势(P＜0.05),左心室肥厚和颈动脉增厚检出率在不同年龄组间无明显的变化趋势;慢性肾功能不全的检出率男性高于女性(P＜0.05),但左心室肥厚、颈动脉增厚、冠心病、脑卒中在不同性别组间检出率差异无统计学意义(P＞0.05). 结论在老年住院高血压患者中继发性高血压主要是由于肾血管性高血压和原发性醛固酮增多症所致;而原发性老年高血压患者的靶器官损害较为普遍,在心、脑、肾三大靶器官疾病中以脑卒中检出率最高.
목적 분석평고노년주원고혈압환자적병인구성급파기관손해정황. 방법 분석고혈압과진단명학적1 270례(년령60～91세)주원환자적병인분류급기합병파기관손해적정황화특점. 결과 노년주원고혈압환자중원발성고혈압1 090례(85.8％),계발성고혈압180례(14.2％);재계발성고혈압중신혈관성고혈압소점비례(67.8％)최고,기차위원발성철고동증다증(23.3％);재1 090례원발성고혈압환자중,유88.3％적환자존재파기관손해혹기타림상질병.파기관손해중경동맥내막증후화좌심실비후적검출솔분별위66.6％화24.0％.재파기관질병중뇌졸중、관심병화만성신공능불전검출솔분별위30.2％、26.7％화10.5％;원발성고혈압환자적뇌졸중、관심병、만성신공능불전적검출솔수년령증가정상승추세(P＜0.05),좌심실비후화경동맥증후검출솔재불동년령조간무명현적변화추세;만성신공능불전적검출솔남성고우녀성(P＜0.05),단좌심실비후、경동맥증후、관심병、뇌졸중재불동성별조간검출솔차이무통계학의의(P＞0.05). 결론 재노년주원고혈압환자중계발성고혈압주요시유우신혈관성고혈압화원발성철고동증다증소치;이원발성노년고혈압환자적파기관손해교위보편,재심、뇌、신삼대파기관질병중이뇌졸중검출솔최고.
Objective To investigate the prevalence of target organ damage and analyze etiology in elderly hospitalized patients with hypertension.Methods A total of 1270 elderly inpatients aged 60 to 91 years from 2008 to 2012 were enrolled.This retrospective study was performed to analyze the etiology and the prevalence of target organ damage in hospitalized hypertensive patients.Results Among elderly hypertensive patients,secondary hypertension accounted for 14.2 ％ (180/1 270) while essential hypertension accounted for 85.8％ (1 090/1 270).In secondary hypertension,renovascular hypertension of atherosclerosis (67.8％) and primary aldosteronism (23.3％) had the higher prevalence rate.Among 1 090 hospitalized patients with essential hypertension,the prevalence of patients with ≥ 1 complications was 88.3 ％.The prevalence of cerebrovascular disease,coronary heart disease and chronic renal failure were 30.2 ％,26.7 ％ and 10.5 ％,respectively.The occurrence rate of the increased carotid intima-media thickness and left type hypertrophy were 66.6 ％ and 24.0 ％,respectively.The prevalence rate of cerebrovascular disease,coronary artery disease and chronic renal failure were increased with aging (P＜0.05).Compared with female,male patients had a higher prevalence rate of chronic renal failure (P＜0.05).Conclusions Secondary hypertension is mainly renovascular hypertension and primary aldosteronism in elderly patients with hypertension.And damage of target organ in elderly patients with primary hypertension is more common,highest with cerebral apoplexy among three target organs such as heart,brain and kidney disease.