青年高血压病120例临床研究与分析

目的：探讨青年原发性高血压（EH）的发病与临床特点。方法：选择年龄18－43岁，无并发症的120例轻中度高血压病患，均为初诊用药且符合1999年WHO／ISH高血压病诊断标准；20例年龄，性别与体重指数相匹配的健康志愿及44－60岁同期初诊，无其它器质性疾病的轻中度高血压病患206例作为对照，观察其诊所血压，24小时动态血压，超声心动图及眼底血管变化，抽取空腹静脉血检测一氧化氮（NO），内皮素（ET）及血脂等生化指标。结果：青年EH组家族史阳性较非青年组明显增多，其单纯舒张期高血压占48％；FS＜35％的发生率为18．4％，非青年组则分别为13．5％（P＜0．05）和13．6％，（P＜0．001）。反映左室舒张功能的指标青年组与对照组相比无统计学意义，而左室重量指数，舒张期室间隔，左室后壁厚度及NO、E与对照组比较均有显性差异（P＜0．05），但与非青年EH组比较差异无统计学意义；非勺型高血压的发生率，脉压差，NO，E在EH两组间比较，差异没有显性。甘油三酯，高密度脂蛋白胆固醇，尿酸，空腹血糖及尿素氮EH两组间比较有统计学差异（P＜0．05），青年高血压眼底血管损害较轻。结论：青年高血压病男性多于女性，单纯舒张期高血压发生率（48％）高于非青年组（13．5％），其左室舒张功能损害不明显，但收缩功能减低的发生率较高（13．6％），动态血压的节律及内皮功能均早期即表现为异常，应及早干预。

Clinical Studies of 120 Young Patients with Essential Hypertension

Objective: The clinical study aim sat investigating and comparing the difference of episode characteristics, ambulatory blood pressure and left ventricular remodeling and function between young and adult patients with essential hypertension.Methods: One hundred and twenty young patients aged from 18 to 43 years, 20 age and sex matched healthy controls and 206 adult patients aged from 44 to 60 years were studied. All patients were measured by ambulatory blood pressure monitoring, echocardiography, radioimmunoas-say and enzymatic assay. Triglyceride, high density lipoprotein , uric acid and urea nitrogen was measured. Results: The results showed that the morbidity of diastolic hypertension was higher in young patients (48%) than in adult patients( 13.5% ,P < 0.05) ) .The morbidity of depressed left ventricular contractility were more in young patients (18.4%) than in adult patients (13.6%). There were significant differences in the thickness of left ventricular posterior wall and left ventricular mass between young subjects and controls, no differences between young patients and the adult patients. Plasma ET was higher in young patients than controls. Plasma NO was smaller in young patients than controls( P < 0.05) . Triglyceride , uric acid and urea nitrogen was higher in adult patients than in young patients with EH (P < 0.05). Conclusion: It is suggested that LV contractility may be depressed in young patients with mild to medium essential hypertension, which the morbidity of diastolie hypertension was higher. The rhythm of ambulatory blood pressure was normal and endotheli-um function was disorder in young patients and the adult patients with EH.