高血压专科3706例住院继发性高血压患者病因构成分析

目的分析2012-2016年河南省人民医院高血压科住院高血压患者9439例中继发性高血压患者3706例病因分类及构成比较,为高血压防治提供病因学参考。方法采用回顾性研究方法,分析9439例住院高血压患者中3706例继发性高血压患者年龄、性别构成及病因分类。结果9439例住院高血压患者中原发性高血压占60.74%(5733例),继发性高血压占39.26%(3706例)。在继发性高血压患者中,心理因素性高血压例数最多(1175例,31.70%),其次例数较多的是阻塞性睡眠呼吸暂停低通气综合征(779例,21.02%)、原发性醛固酮增多症(728例,19.64%)、肾血管性高血压(702例,18.94%)。与原发性高血压患者相比,心理因素性高血压、原发性醛固酮增多症、肾血管性高血压、甲状腺功能减退症、青光眼患者年龄较大,心理因素性高血压、内分泌性继发性高血压的女性患者较多(P<0.05)。与原发性高血压患者相比,继发性高血压患者的年龄(50.2±15.0)比(46.6±15.2)岁]较大、男性患者比例54.6%(2024/3706)比64.5%(3695/5733)]较小(均P<0.05)。继发性高血压和原发性高血压患者中女性的平均年龄高于男性(P<0.05)。结论2012-2016年高血压住院患者中继发性高血压占39.26%,高于国内外文献报道。住院的高血压患者心理因素性高血压比例居于首位,阻塞性睡眠呼吸暂停低通气综合征、原发性醛固酮增多症、肾血管性高血压的比例也较高。年龄较大的高血压患者中也筛查出不少继发性高血压。

The causes of secondary hypertension in a tertiaty hospital

Objective To analyze the etiological classification and composition of 3706 patients with secondary hypertension from 9439 hypertensive inpatients of the Hypertension Department of Henan Provincial People’s Hospital from 2012 to 2016,so as to provide etiological reference for the prevention and treatment of hypertension,and improve the attention of clinicians to the screening of secondary hypertension.Methods A retrospective study was conducted to analyze the age,sex composition and etiological classification of 3706 patients with secondary hypertension from 9439 hypertensive inpatients.Results Essential hypertension accounted for 60.74%(5733 cases)and secondary hypertension accounted for 39.26%(3706 cases)of 9439 hypertensive inpatients.Among the secondary hypertension patients,the most frequent cases were hypertension caused by psychological factors(1175 cases,31.70%),followed by obstructive sleep apnea hypopnea syndrome(779 cases,21.02%),primary aldosteronism(728 cases,19.64%)and renovascular hypertension(702 cases,18.94%).Compared with the patients with essential hypertension,the patients with hypertension caused by psychological factors,primary aldosteronism,renovascular hypertension,hypothyroidism and glaucoma were older,and the female patients with psychological factors hypertension and endocrine secondary hypertension were more(P<0.05).Compared with the patients with essential hypertension,the patients with secondary hypertension were older(50.2±15.0)vs(46.6±15.2)years]and the proportion of male patients was smaller54.6%(2024/3706)vs 64.5%(3695/5733)](both P<0.05).The average age of female patients with secondary hypertension and essential hypertension was significantly higher than that of male patients(P<0.05).Conclusion From 2012 to 2016,39.26%of hospitalized patients with hypertension had secondary hypertension,which was higher than that reported in domestic and foreign literatures.The proportion of secondary hypertension caused by anxiety disorder and depression disorder was the highest.Obstructive sleep apnea hypopnea syndrome,primary aldosteronism and renovascular hypertension were also the common causes of secondary hypertension.Secondary hypertension was also screened out in older hypertensive patients.