老年男性高血压病患者缺血性脑血管病患病率及与血压达标的相关性研究  

Morbidity of ischemic cerebrovascular diseases in elderly male hypertensive patients and its correlation with hypertension control

作　　者：杜辉[1] 蔡毅[2] 王晓曦[1] 范利[1] 崔华[1] 

机构地区：[1]解放军总医院南楼老年心内科,北京100853 [2]解放军总医院南楼肿瘤内科,北京100853

出　　处：《中华保健医学杂志》2016年第2期96-99,共4页Chinese Journal of Health Care and Medicine

基　　金：保健专项科研课题(13BJZ43)

摘　　要：目的对全程管理良好的老年男性高血压病患者缺血性脑血管疾病患病率及与血压达标的相关性研究。方法选取2011年10月-2014年4月在解放军总医院老年病房就诊〉60岁的男性患者,按既往有无高血压病史及当前的血压控制情况分为3组,正常血压组、高血压控制达标组和高血压控制不达标组。调查缺血性脑血管疾病（包括短暂性脑缺血发作、腔隙性脑梗死和脑血栓）的检出率及与血压达标的相关性。结果该群体中高血压患者的血压控制达标率（79.23%）远高于一般人群。血糖、血脂、吸烟等危险因素控制较好。正常血压组、高血压控制达标组和高血压控制不达标组患者的全部缺血性脑血管疾病（包括短暂性脑缺血发作、腔隙性脑梗死和脑血栓）患病率分别为10.50%、22.60%和42.20%。其中,短暂性脑缺血发作（TIA）的患病率3组相近似,分别为1.30%vs 1.30%vs 2.00%;高血压控制不达标组和高血压控制达标组腔隙性脑梗死和脑血栓的患病率均明显高于正常血压组（22.50%vs 10.30%vs 6.10%;17.60%vs 11.10%vs 3.10%）。对缺血性脑血管病（包括TIA、腔隙性脑梗死和脑血栓）的总患病率进行比较发现,高血压控制达标组和控制不达标组的发病风险也明显高于正常血压组（OR 2.178,95%CI为1.328-3.573,P=0.002;OR 4.710,95%CI为2.596-8.544,P=0.000）。结论老年男性高血压患者,理想血压的控制在缺血性脑血管疾病的发生和发展中发挥了重要的作用,年龄和伴随疾病等其他因素也会影响患者预后。Objective To investigate the correlation between morbidity of ischemic cerebrovascular diseases in elderly male hypertensive patients under good hypertension management and their hypertension control status. Methods Male hypertensive patients over 60 years of age from Geriatric Ward and Clinic of the PLA General Hospital were enrolled from October 2011 to April2014,and were divided into three groups according to their hypertension history and hypertension control status ： normotensive group,well-controlled hypertensive group and poorly-controlled hypertensive group. The correlation between prevalence of ischemic cerebrovascular diseases（including transient ischemic attack（TIA）,lacunar infarction,cerebral thrombosis） and the status of hypertension control were studied. Results The good blood pressure control rate of the studied subjects（79.23%） was much higher than that of general population. Risk factors such as blood glucose,blood lipid and smoking were all well controlled. Overall morbidity of ischemic cerebral diseases showed a rising trend from normotensive group to well-controlled hypertensive group and to poorly-controlled hypertensive group（10.50% vs 22.60% vs 42.20%）. The morbidity rates of TIA in three groups were close to each other,whereas the morbidity rates of lucunar infarction and cerebral thrombosis showed an obvious decline from poorly-controlled hypertensive group to well-controlled hypertensive group and to normotensive group（22.50% vs 10.30% vs 6.10%;17.60% vs11.10% vs 3.10%）. The onset risks of cerebrovascular diseases were also higher in well-controlled group and poorly-controlled compared to normotensive group（OR 2.178,95% CI 1.328 ~ 3.573,P = 0.002;OR 4.710,95% CI 2.596 ~ 8.544,P = 0.000）.Conclusion For elderly male hypertensive patients,even though control on blood pressure and risk factors such as blood glucose,blood lipid,obesity,etc. can reduce the morbidity of cerebrovascular diseases,occurrence of hypertension and blood pressure management still play an impo

关 键 词：高血压 脑血管疾病 现患率 达标 

分 类 号：R544.1[医药卫生—心血管疾病]