老年高血压患者危险因素分析及其对靶器官损害的影响  

Clustering of risk factors and their effects on target organ damage in elderly patients with hypertension

作　　者：贾国栋[1] 宫桂花[1] 孟萍[1] 鲍莲华[1] 傅淑宏[2] 

机构地区：[1]解放军总医院南楼保健科,北京100853 [2]解放军总医院南楼检验科,北京100853

出　　处：《中华老年心脑血管病杂志》2012年第1期22-25,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：全军医药卫生科研基金资助(10BJZ02)

摘　　要：目的分析老年高血压患者多重危险因素的聚集和其对靶器官损害的特征。方法选择老年高血压患者416例,根据合并危险因素的个数分为:A组(单纯高血压)24例,高血压合并1、2、3及≥4项危险因素分别为B组75例、C组125例、D组127例和E组65例,综合评估危险因素及其对靶器官损害的情况。结果与A组比较,D、E组患者体重指数、血糖、TG、LDL-C、肌酐、尿酸等指标明显升高(P<0.05),且需要更多的降压药物种类(P<0.05),C、D、E组患者左心室重量指数、颈动脉内膜中层厚度和尿微量白蛋白/肌酐均明显升高(P<0.05),内生肌酐清除率明显下降(P<0.05),并发冠心病、脑血管病和慢性肾脏疾病的发生率明显增加(P<0.05)。结论老年高血压患者以多重危险因素聚集为特征,危险因素越多,靶器官损害和并发症的发生越多,需要更多抗高血压药物联合应用以控制血压。Objective To assess the clustering of cardiovascular risk get organ damage sion patients were out additional risk in elderly p divided into factor（gro atients with hypertension. Methods five （group B,75 cases） ,2（group C,12 factors and their effects 416 treated elderly hy groups based on the number of risk factors ： hypertension with- ,24 cases）,and the other four groups were complicated with 1 5 cases） ,3（group D,127 cases） and ≥4（group E,65 cases） risk factors. The structure and function of heart in order to evaluate the damage of target o with three or more risk factors showed sign and carotid artery were rgan and the ificantly high morbidity. examl Resul er levels of BMI, ned by ultrasonography ts The patient groups plasma glucose, triglyceride, LDL-C cholesterol, serum creatinine and serum uric acid, and needed greater number of antihypertensive drugs,compared with other groups（P〈0. 05）. The patient groups with two or more risk factors showed significantly higher levels of LVMI,IMT and MAU/Cr compared with group A（P%0.05） ,and significantly lower levels of the creatinine clearance（P〈0.05）. In addition,they showed significantly higher incidences of coronary heart disease and cerebrovascular disease and chronic kidney disease compared with group A（P〈0.05）. Conclusion These results suggest that the hypertensive patients with clustering risk factors required greater number of antihypertensive drugs. The more additional risk factors exit, the more target organ damages and higher morbidity occur,and more intensive intervension for not only blood pressure but also for other complicated risk factors are required.

关 键 词：高血压 危险因素 冠心病 脑血管障碍 肾炎 抗高血压药 

分 类 号：R544.1[医药卫生—心血管疾病]