广东省江门市脾肾阳虚型高血压的流行病学研究

Epidemiological Study of Hypertension with Deficiency of Spleen-kidney Yang Type in Jiangmen City Guangdong Province

目的:研究脾肾阳虚型高血压患者的流行病学情况及其相应的临床特征。方法:随机选择2018例临床诊断为高血压的患者,对患者的一般资料进行采集,对符合"肝阳上亢"型及"脾肾阳虚"型两个证型特征的患者,与正常对照组进行相比较,进一步检测其血液流变学、肾素-血管紧张素系统、靶器官损伤、性激素及β2-微球蛋白、胰岛素抵抗、动态血压等指标。结果:在2018例高血压患者中"脾肾阳虚"型共有142例,占7.0%。与正常人组比较,EH"脾肾阳虚"型血液流变学各项指标值、胰岛素敏感指数(ISI)、肾素(PRA)、血浆心钠素(ANP)均小于正常组,有显著性差异(P<0.05);左室舒张功能中A(m/s),A/E,Ai/Ei显著升高(P<0.05),E(m/s)和Ei(m)显著降低(P<0.01)或(P<0.05);白天平均收缩压(dmsbp)以及夜间平均收缩压(nmsbp)则显著升高(P<0.05);血浆E2及E2/T显著升高(P<0.05),而血浆T却降低(P<0.05)。结论:存在EH"脾肾阳虚"型高血压患者,其大约占高血压患者各型总数的7%,与正常人相比,有其独特的临床特征。

Objective ：To investigate the current prevalence of hypertension with deficiency of spleen - kidney yang type and correlative clinical features of this type. Methods：Totally 2018 cases with hypertension were selected random, and their information were record. Patients with hypertension who accord with the diagnose of abundant of liver yang type and deficiency of spleen - kidney yang type were sort out. Then this two type of cases compared with normal control group in hemorheology ,renin - angiotensin system, the damage of target orga, sex hormone, β2 - microglobulin, insulin resistance and ambulatory blood pressure monitoring by checking their relevance index. Result ：There were 142 cases with deficiency of spleen - kidney yang type, and it was account for 7.0% In all 2018 patients with hypertension. Compared with normal control group, various index of hemorheology, ISI, PRA and ANP of deficiency of spleen - kidney yang type group were obviously less （ P 〈 0.05 ） ; The score of A, A/E, Ai/Ei of left ventricular contraction function, DMSBP, NMSBP ,PGE - 2 and E2/T in deficiency of spleen - kidney yang type group were notable higher than normal control group （ P 〈0.05） ; Hewever, the score of E and Ei of left ventricular contraction function and T concentrations in blood plasma in deficiency of spleen - kidney yang type group were remarkable less than normal control group （ P 〈 0. 05 or P 〈 0. 01 ）. Conclusion ： Deficiency of spleen - kidney yang type was one type of hypertension, and it was account for 7.0% in all type of hypertension. Compared with normal person, this tyge of hyDertension has its unique clinical features.