摘要
目的探讨继发性高血压的临床表现、辅助检查的特异性,提高继发性高血压的诊疗水平。方法回顾性分析76例继发性高血压患者和67例原发性高血压患者的血钾(K+)、三酰甘油(TG)、总胆固醇(TC)、空腹血糖(G lu)、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)水平,调查其家族史,统计其初诊血压水平,就诊年龄,病程及主诉特点,对比两组患者所观察临床指标的差异:分析76例原发性高血压患者的CT定位诊断及术后病理诊断。结果继发性高血压患者的病程(2.19±0.23)年及血钾水平(3.37±0.82)mmol/L明显小于原发性高血压患者病程(5.36±0.50)年及血钾水平(4.00±0.66)mmol/L;TC、G lu、BUN、Cr、UA,初诊收缩压水平(SBP)之间差异均有统计学意义(P<0.05);就诊时舒张压(DBP)水平,就诊年龄,有高血压家族史者所占比例及三酰甘油水平之间差异无统计学意义。嗜铬细胞瘤及原发性醛固酮增多症中CT诊断敏感性为69%。结论①继发性高血压病程较短,多不合并血脂代谢异常,常有电解质紊乱及肾功能不全,发病年龄及就诊年龄较轻者高度怀疑继发性高血压;②对于可疑继发性高血压患者,常规行电解质,双肾及双侧肾上腺B超及CT检查,可提高继发性高血压的检出率;⑧继发性高血压以嗜铬细胞瘤最多见(31.58%),其次为原发性醛固酮增多症(26.32%),肾上腺瘤(11.84%),肾衰竭(10.53%),肾上腺增生(7.89%),系统性红斑狼疮(3.95%)等。
Objective To explore the cilinical manifestation, characteristic of auxiliary examination in patients with secondary hypertension,and to improve it＇s diagnosis and treatment. Methods An the 143 patients are divided into two groups,one is with essential hypertension （76 patients）, the other with secondary hypertension （67patients）. To analyze and compare retrospectively the levels of kalium（K） ,blood presure（BP） ,lipid（ TC ,TG） ,fasting blood sugar（Glu） ,urea nitrogen （BUN）, creatinine（Cr） ,uric acid（UA） ,family history;age of visit,course of disease,chief complait and analyze the information of CT and operational results. Results The course of disease （2.19 ±0.23 ） years and level of kalium （3.37 ±0.82） mmol/L of secondary hypertension is less significantly than that of essential hypertention. （5.36 ±0.50 ） years. （4. 00：1=0.66 ） mmoL/L. There is significant difference between levels of SBP of visit, Glu, TC, BUN, Cr, UA （ P〈0.05 ）. And there is no significant difference between DBP, age of visit, family history, and level of TG. The sensitivity of CT to dignose the pheochmmocytoma, and primary aldosteronism is about 69%. Conclusion （1）Secondary hypertension has shorter course of disease, and more secondary hypertension is pheochromocytoma（ 31. 58% ） , then is primary aldosteronism （26.32%） , suprarenoma （ 11.84% ） , renal failure （ 10.53% ）, adrenal hyperplasia （7.89%） ,systemic lupus erythematosus （3.94%） ,and so on.
出处
《四川医学》
CAS
2010年第2期179-181,共3页
Sichuan Medical Journal
关键词
继发性高血压
病程
血脂水平
血钾
CT
secondary hypertension
conrse of disease
level of lipid and kalium
computer tomography
