摘要
目的评估住院绝经后原发性高血压患者的临床特点。方法选择女性原发性高血压患者727例，其中绝经前组240例，绝经后组487例（包括围绝经期34例）。所有患者均完成了入院时的病史询问、体格检查以及实验室检查。回顾性分析绝经后组临床特点。结果绝经后组年龄、病程、腰臀比、TG、TC、LDL—C、空腹血糖、餐后2h血糖、胰岛素抵抗指数、尿酸、C反应蛋白水平较绝经前组明显增高，Z4h尿钠、24h尿钾较绝经前组明显降低；绝经后组代谢综合征、糖尿病、葡萄糖耐量减退、空腹葡萄糖受损合并葡萄糖耐量减退、高TC血症、混合型高脂血症并发比例明显高于绝经前组，差异有统计学意义（P〈0．05，P〈0．01）。绝经后组左心室肥厚、颈动脉斑块、慢性肾脏病较绝经前组更常见（P〈0．01）。尿酸增高是绝经后高血压左心室肥厚的独立危险因素（OR=1．005，95％CI：1．002～1．008，P=0．003）。结论绝经后高血压患者存在糖脂、尿酸代谢紊乱、尿钠排出减少、中心性肥胖等特点，其代谢综合征、难治性高血压发生比例增高，靶器官受损情况亦较绝经前发生比例增加。
Objective To study the clinical characteristics of postmenopausal patients with essential hypertension （EH）. Methods Seven hundred and twenty-seven female EH patients were divided in premenopausal group （n=240） and postmenopausal group （n=487）. Their medical history was recorded. The patients underwent physical examination and laboratory testing. The clinical charac- teristics of postmenopausal group were retrospectively analyzed. Results The age was older,the course of hypertension was longer,the waist/hip ratio and the serum levels of TG,TC,LDI. C, fasting blood glucose,24 h postprandial blood glucose, HOMA-IR and uric acid were significantly higher while the 24 h urinary sodium and potassium levels were significantly lower in postmeno- pausal group than in premenopausal group. The incidence of metabolic syndrome,diabetes melli- tus,impaired blood glucose tolerance,impaired fasting blood glucose and impaired glucose toler- ance,hypercholesterolemia, combined hyperlipidemia was significantly higher in postmenopausal group than in premenopausal group （P〈 0. 05, P 〈 0. 01）. The left ventricular hypertrophy （LVH）, carotid plaques, chronic kidney disease were more common in postmenopausal group than in premenopausal group. High uric acid level was the independent factor for LVH in postmenopa- usal hypertensive patients （OR= 1. 005,95 % CI. 1. 002-1. 008,P=0. 003）. Conclusion Postm- enopausal EH patients are characterized by metabolism disturbance of glucose, lipid, and uric acid, with a higher incidence of metabolic syndrome, refractory hypertension and target organ damage.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2014年第4期360-363,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
高血压
绝经期
糖尿病
高脂血症
C反应蛋白质
葡糖耐量试验
尿酸
hypertension
menopause
diabetes mellitus
hyperlipidemias
C-reactive protein
glu cose tolerance test
uric acid
