高血压急症和亚急症患者的临床特征及影响因素研究  

Clinical Characteristics and Influencing Factors of Hypertensive Emergency and Sub-Emergency Patients

作　　者：李志豪 王庆航[1,2] 周碧蓉 LI Zhihao;WANG Qinghang;ZHOU Birong(Department of Cardiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Cardiology,Lu'an Hospital of Anhui Medical University,Lu'an 237008,China)

机构地区：[1]安徽医科大学第一附属医院心血管内科,安徽省合肥市230022 [2]安徽医科大学附属六安医院心血管内科,安徽省六安市237008

出　　处：《实用心脑肺血管病杂志》2025年第6期25-29,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：安徽省学术技术带头人科研活动项目(2021D279);安徽省卫生适宜技术推广项目(2018TG03)。

摘　　要：目的分析高血压急症和亚急症患者的临床特征,并探讨高血压急症的影响因素。方法选取2022年8月—2024年8月安徽医科大学第一附属医院心血管内科收治的112例高血压急症患者作为高血压急症组,317例高血压亚急症患者作为高血压亚急症组。收集所有患者的临床资料,包括年龄、性别、BMI、血压、静息心率、高血压病程、有无吸烟史、有无饮酒史、有无高血压家族史、有无疾病史、营养状况、降压药服用情况、服药依从性、首诊时主要临床表现、实验室检查指标及高血压急症患者靶器官损伤类型。高血压急症影响因素分析采用多因素Logistic回归分析。结果高血压急症组男性比例、有糖尿病史者占比、有高尿酸血症史者占比、控制营养状态(CONUT)评分、服药依从性差者占比及首诊时主要症状为呼吸困难/胸闷、胸痛、神经系统表现者占比高于高血压亚急症组,静息心率快于高血压亚急症组,首诊时主要症状为头晕、其他者占比低于高血压亚急症组(P<0.05)。高血压急症组血肌酐、血尿酸、C反应蛋白、脑钠肽、超敏心肌肌钙蛋白T、乳酸脱氢酶、D-二聚体、纤维蛋白原高于高血压亚急症组,估算肾小球滤过率低于高血压亚急症组(P<0.05)。高血压急症患者靶器官损伤类型:急性心力衰竭38例(占33.9%),急性脑卒中25例(占22.3%),急性冠脉综合征22例(占19.6%),高血压脑病11例(占9.8%),急性肾功能不全9例(占8.0%),急性主动脉夹层4例(占3.5%),恶性高血压3例(占2.9%)。多因素Logistic回归分析结果显示,糖尿病史、高尿酸血症史、CONUT评分及服药依从性差是高血压急症的影响因素(P<0.05)。结论高血压急症多见于男性及服药依从性差的患者,其首诊主要症状为呼吸困难/胸闷、胸痛及神经系统表现,常见靶器官损伤为急性心力衰竭、急性脑卒中和急性冠脉综合征;高血压亚急症患者首诊�Objective To analyze the clinical characteristics of patients with hypertensive emergency and subemergency,and to explore the influencing factors of hypertensive emergencies.Methods A total of 112 patients with hypertensive emergencies admitted to the Department of Cardiology of the First Affiliated Hospital of Anhui Medical University from August 2022 to August 2024 were selected as the hypertensive emergency group,and 317 patients with hypertensive subemergency were selected as the hypertensive sub-emergency group.The clinical data of all patients were collected,including age,gender,BMI,blood pressure,resting heart rate,duration of hypertension,smoking history,drinking history,family history of hypertension,disease history,nutritional status,antihypertensive drug use,medication compliance,main clinical manifestations at the first diagnosis and laboratory indexes,and the target organ damage types in patients with hypertensive emergency were collected.Multivariate Logistic regression analysis was used to analyze the influencing factors of hypertensive emergency.Results The proportion of males,the proportion of patients with a history of diabetes,the proportion of patients with a history of hyperuricemia,Controlling Nutritional Status(COUNT)score,the proportion of patients with poor medication compliance,the proportion of patients with dyspnea/chest tightness,chest pain and neurologic manifestations at the first diagnosis in the hypertensive emergency group were higher than those in the hypertensive sub-emergency group,the resting heart rate was faster than that in the hypertensive sub-emergency group,and the proportion of patients with dizziness and other symptoms at the first diagnosis was lower than that in the hypertensive sub-emergency group(P<0.05).Serum creatinine,serum uric acid,C-reactive protein,brain natriuretic peptide,high sensitive cardiac troponin,lactate dehydrogenase,D-dimer and fibrinogen in hypertensive emergency group were higher than those in hypertensive sub-emergency group,and estimated glom

关 键 词：高血压 高血压急症 高血压亚急症 临床特征 影响因素分析 

分 类 号：R544.1[医药卫生—心血管疾病]