单中心住院患者内分泌性高血压病因构成及基本临床情况分析  

Analysis of Etiology and Basic Clinical Situation of Endocrine Hypertension in Single-center Hospitalized Patients

作　　者：宋晶京 刘小宁[1] 蔡军[1] 马文君[1] 张慧敏[1] 宋雷[1] 吴海英[1] 周宪梁[1] 卞瑾[1] SONG Jing-jing;LIU Xiao-ning;CAI Jun;MA Wen-jun;ZHANG Hui-min;SONG Lei;WU Hai-ying;ZHOU Xian-liang;BIAN Jin(Center of Hypertension,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院,北京协和医学院,国家心血管病中心,阜外医院高血压中心,北京市100037

出　　处：《中国分子心脏病学杂志》2021年第4期4066-4071,共6页Molecular Cardiology of China

基　　金：中央高校基本科研业务费专项资金资助(2018-XHQN11)—探索新生物标志物评价大动脉炎活动性的前瞻性研究。

摘　　要：目的分析近2年高血压住院患者中内分泌性高血压的病因构成及临床特点。方法回顾性分析阜外医院高血压病房2016年1月至2017年12月因高血压首次住院的患者中内分泌性高血压的病因构成及基本临床情况。结果高血压患者4782例,其中内分泌性高血压371例,占7.76%。内分泌性高血压的病因构成为:原发性醛固酮增多症247例(66.58%),甲状腺功能减退症52例(14.02%),甲状腺功能亢进症38例(10.24%),多囊卵巢综合征22例(5.93%),皮质醇增多症8例(2.16%),嗜铬细胞瘤4例(1.08%)。与原发性高血压组[(50.31±15.10)岁]相比,原发性醛固酮增多症组年龄稍小[(48.21±11.63)岁],甲状腺功能异常组年龄较大[(55.20±14.68)岁],多囊卵巢综合征组明显年轻[(33.03±3.01)岁],差异均有统计学意义(P<0.05)。原发性醛固酮增多症组中男性占59.92%,甲状腺功能异常组中女性占56.67%,多囊卵巢综合征组均为育龄期年轻女性,皮质醇增多症组以青年女性为主(占75%)。与原发性高血压组相比,内分泌性高血压组血压高[收缩压:(150.23±20.51)mmHg比(143.21±20.01)mmHg,舒张压:(91.38±15.72)mmHg比(87.20±15.03)mmHg],尿微量白蛋白/肌酐高[(43.12±79.41)mg/g比(39.41±134.57)mg/g],并发外周动脉狭窄/闭塞者多(9.43%比4.13%),差异均有统计学意义(P<0.001)。结论内分泌性高血压并不少见,原发性醛固酮增多症是最常见病因。内分泌性高血压多为中青年患者,且血压高,靶器官损害重。Objective To analyze the etiology and clinical features of endocrine hypertension in hospitalized patients with hypertension in the past two years.Methods The etiology and basic clinical situation of endocrine hypertension were retrospectively analyzed in patients hospitalized for the first time due to hypertension in Fuwai Hospital Hypertension Unit from January 2016 to December 2017.Results There were 4782 cases of hypertension,including 371 cases of endocrine hypertension,accounting for 7.76%.The cause composition of endocrine hypertension consisted of 247 cases(66.58%)of primary aldosteronism(PA),52 cases(14.02%)of hypothyroidism,38 cases(10.24%)of hyperthyroidism,and 22 cases(5.93%)of polycystic ovary syndrome(PCOS),8 cases(2.16%)of Cushing syndrome(CS),4 cases(1.08%)of pheochromocytoma.Compared with the primary hypertension group[(50.31±15.10)years old],the PA group was younger[(48.21±11.63)years old],and the thyroid dysfunction group was older[(55.20±14.68)years old],the PCOS group was significantly younger[(33.03±3.01)years old],all the differences were statistically significant(all P<0.05).In the PA group,59.92% were males,and 56.67% were females in the thyroid dysfunction group.The PCOS group patients were all young women of reproductive age,and the group of CS was mainly young women(75%).Compared with the primary hypertension group,the endocrine hypertension group had higher blood pressure[systolic blood pressure(150.23±20.51)vs(143.21±20.01)mmHg,diastolic blood pressure(91.38±15.72)vs(87.20±15.03)mmHg],higher urinary albumincreatinin ration[(43.12±79.41)vs(39.41±134.57)mg/g],and more complicated peripheral arterial stenosis/occlusion(9.43%vs 4.13%),with statistically significant differences(all P<0.001).Conclusion Endocrine hypertension is not uncommon,and PA is the most common cause.Most of the patients with endocrine hypertension are young or middle-aged,with higher blood pressure and severer target organ damage.

关 键 词：内分泌性高血压 病因学 原发性醛固酮增多症 

分 类 号：R544.1[医药卫生—心血管疾病]