老年继发性高血压46例临床分析

The analysis of clinical characteristic of senile secondary hypertension

目的:探讨老年继发性高血压的临床特点及诊断思路,提高老年继发性高血压的诊疗水平。方法:回顾性分析46例老年继发性高血压患者和50例老年原发性高血压患者的血钾(K+)、尿素氮(BUN)、肌酐(Cr)、血管紧张素/醛固酮(ARR)、双肾上腺B超或CT,以及发病年龄、血压水平、降压效果等,分析老年继发性高血压的临床特点。结果:老年继发性高血压患者的收缩压(SBP)、血钾水平之间差异有统计学意义(P<0.05)。尿素氮(BUN)、肌酐(Cr)、空腹血糖(Glu)等无统计学差异。结论:①老年继发性高血压患者容易误诊,常因电解质紊乱、降压效果差而怀疑继发性高血压。②对于可疑继发性高血压患者,常规行电解质、双肾上腺B超或CT检查,可提高检出率。③老年继发性高血压以肾上腺增生(36.96%)、肾上腺腺瘤(19.57%)、原发性醛固酮增多症(26.09%)多见。

Objective： To explore the clinical characteristic and diagnosis of senile secondary hypertension,and to improve it＇s diagnosis and treatment.Methods： One group was with essential hypertension（50 patients）,the other was with secondary hypertension（46 patients）.To analyze and compare retrospectively the levels of Kalium（K＋）,blood pressure（BP）,etc.and analyze the information of CT and operational results.Results： The level of Kalium of secondary hypertension was less significantly than that in essential hypertension.There was significant difference between levels of DBP（P〈0.05）.And there was no significant difference between Glu、BUN、Cr.Conclusions ：Senile secondary hypertension easily misdiagnosis.To check electrolyte、adrenal gland CT or type-B ultrasonic can increase detection rate.