老年女性Stanford B型主动脉夹层患者的高血压特征及降压治疗  

Features and treatments of hypertension in elderly females with Stanford type B aortic dissection

作　　者：孙鸣宇[1] 韩雅玲[1] 王效增[1] 荆全民[1] 王祖禄[1] 

机构地区：[1]沈阳军区总医院心内科全军心血管病研究所,沈阳110016

出　　处：《岭南心血管病杂志》2013年第1期24-27,47,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的总结老年女性Stanford B型主动脉夹层(aortic dissection,AD)患者的高血压特征及降压治疗方法。方法选择2002年4月至2011年7月期间入住沈阳军区总医院治疗且年龄≥60岁的Stanford B型AD患者,按性别分为老年男性组(67例)及老年女性组(41例),年龄分别为(66.8±5.3)岁和(65.5±4.6)岁。对两组的高血压特征及降压治疗情况进行回顾性分析。结果老年男性组和老年女性组年龄及吸烟、糖尿病、冠状动脉粥样硬化性心脏病(冠心病)、高脂血症、原发性高血压(高血压)、穿透性动脉粥样硬化性溃疡及伴发心功能不全、肾功能不全、低氧血症比例比较,差异无统计学意义(P>0.05)。老年女性组高血压病史知情比例低于老年男性组[71.1%(27/38)vs.88.9%(56/63),P<0.05],入院首诊高血压比例高于老年男性组[28.9%(11/38)vs.11.1%(7/63),P<0.05],差异均有统计学意义。两组高血压1级、2级、3级比例比较,差异无统计学意义(P>0.05)。两组入院最高收缩压,入院脉压差,治疗后收缩压、舒张压及脉压差比较,差异无统计学意义(P>0.05);但老年女性组入院最高舒张压高于老年男性组,差异有统计学意义[(117.4±23.8)mm Hg vs.(103.9±17.3)mm Hg,P<0.05;1 mm Hg=0.133 kPa]。两组患者多采用联合药物降压,选用静脉用降压药物比例及口服降压药物种类数比较,差异无统计学意义(P>0.05)。老年女性组应用利尿药的比例高于老年男性组,差异有统计学意义[34.2%(13/38)vs.9.5%(6/63),P<0.05]。随访期间两组血压治疗达标率、总病死率及夹层相关病死率比较,差异无统计学意义(P>0.05)。结论老年女性Stanford B型AD患者对高血压的知晓率低,入院舒张压高,经正规的降压治疗后,可获得较理想的血压达标率。对老年女性患者需重视早期诊断,合理用药,积极控制血压,以期降低病死率,改善预后。Objectives To summarize the features and treatments of hypertension in elderly females with Stanford type B aortic dissection. Methods Retrospectively analyzed the features and treatments of hypertension in elderly male group （t〉60 years old,n=67） and elderly female group （≥60 years old, n=41 ） who were suffered from Stanford type B aortic dissection and hospitalized in Shenyang General Hospital between April 2002 and July 2011. Average ages of the two groups were （66.8±5.3） and （65.5±4.6） respectively. Results Average ages were similar in the two groups （P 〉0.05）. Proportions of patients accompanied with smoking history,diabetes mellitus,coronary artery disease, hyperlipemia, hypertension, atherosclerotic ulcers, cardiac insufficiency, renal inadequacy and hyoxemia had no statistical differences between the two groups （P〉0.05）. Compared to the elderly male patients,the femal patients were less aware of their histories of hypertension, while the first-time diagnosis of hypertension was made more frequently in the elderly female patients E71.1% （27/38） vs. 88.9% （56/63）, P〈0.05; 28.9% （11/38） vs. 11.1% （7/63）, P〈0.05]. Proportions of grade 1, grade 2 and grade 3 hypertension had no statistical differences between the two groups （P〉 0.05）. The highest systolic pressures and pulse pressures on admission, the average systolic pressures, diastolic pressuresand pulse pressures after treatments had no statistical differences between the two groups （P〉0.05）. The highest diastolic pressures on admission were higher in elderly female group than that in elderly male group [ （117.4±23.8） mm Hg vs. （103.9±17.3） mm Hg, P〈0.05]. Combined treatments were applied frequently in both groups. Usages of intravenous drugs and types of oral hypotensive drugs had no significant differences between the two groups （P〉0.05）. Diureticum was used more often in elderly female group when compared to elderly male group [34.2% （13/38） vs. 9.5% （6/63）, P�

关 键 词：主动脉疾病 主动脉夹层 女性 老年 高血压 

分 类 号：R543.1[医药卫生—心血管疾病]