新疆地区10 011例住院高血压患者病因构成的分析

Analysis of etiological factors of hypertension in Xinjiang province:report of 10 Oil in-patients

目的:了解新疆地区高血压患者病因学及其在不同性别、年龄、民族间的分布情况。方法:采用回顾性研究方法,分析新疆医科大学第一附属医院住院治疗的10 011例高血压患者的病因构成及其在不同性别、年龄段、民族中构成比的差异。结果:①10 011例住院高血压患者中原发性高血压(EH)和继发性高血压(SH)的构成比分别为86.8%(8 685例)和13.2%(1 326例),SH中肾性高血压所占构成比最高(40.6%,539例),其次为内分泌性高血压(21.2%,281例)、睡眠呼吸暂停综合征(OSAHS,20.8%,276例)和焦虑症(14.3%,189例);肾性高血压中肾实质性高血压和肾血管性高血压分别占SH的31.1%(413例)和9.5%(126例);内分泌性高血压中原发性醛固酮增多症(原醛)、嗜铬细胞瘤(嗜铬)、库欣综合征在SH中的构成比分别为10.5%(139例)、4.4%(59例)、4.4%(58例)。②不同性别、发病年龄段、民族间高血压病因存在差异,男性肾性高血压(6.1%)、肾实质性高血压(4.9%)、OSAHS(4.2%)高于女性(分别为4.6%、3.3%和1.2%,P<0.05),而女性库欣综合征(0.9%)、焦虑症(2.4%)高于男性(0.3%和1.4%,P<0.05)。青年中肾性高血压(包括肾实质性高血压和肾血管性高血压)、内分泌性高血压、库欣综合征构成比高于中年和老年(P<0.05);青中年原醛、嗜铬细胞瘤、OSAHS构成比高于老年(P<0.05);维吾尔族、哈萨克族肾性高血压、肾实质性高血压、肾血管性高血压构成比高于汉族,汉族中原醛的构成比高于维吾尔族,OSAHS的构成比维吾尔族高于汉族(P<0.05);哈萨克族嗜铬细胞瘤、焦虑症构成比高于汉族和维吾尔族(P<0.05)。③肾血管性高血压中动脉粥样硬化是其主要病因。结论:①EH仍然是高血压的主要病因,继发性高血压的构成比呈上升趋势,肾性高血压仍然是SH的主要病因,其次为内分泌性高血压、OSAHS、焦虑症;内分泌高血压中原醛的构成比最高,且其检出率有上升趋势。②不同性别、发病年龄段、民族间高血压病因构成不同。③动脉粥样硬化是肾血管性高血压主要病因。

Objective：To analyze the etiological factors of hypertension in Xinjiang province, and investigate the distribution of hypertension in gender, nationalities and different ages. Methods=Retrospeetive study concerning e-tiology of hypertension and its distribution in gender, nationality and age was performed in 10 011 cases of hyper-tension admitted to the First Hospital Affiliated to Xinjiang Medical University. Results： ① Among 10 011 in-pa-tients with hypertension, there were 8 685 cases of essential hypertension （EH,86.8%）, and 1 326 cases of sec-ondary hypertension （SH, 13.2%）. In patients with SH, the incidence of renal hypertension was the highest （40.6%, 539 cases）, followed by endocrine hypertension （21.2%, 28t cases）, obstructive sleep apnea-hypopnea syndrome （OSAHS, 20.8%, 276 cases）, and anxiety disorder （14.3%, 189 cases）. Among the patients with the renal hypertension, the respective incidence of renal parenchymal hypertension and renovaseular hypertension was 31.1 % （413 cases）and 9.5 % （126 cases）. Of the endocrinal hypertension, the common etiology was primary al-dosteronism, pheochromoeytoma and Cushing＇s syndrome, and their incidence was 10.5% （139 cases）, 4.4% （59 cases）and 4.4% （58 cases）, respectively, among SH patients. ②Etiology was different among the patients of different gender, nationalities and ages. The incidence of renal hypertension, renal parenchymal hypertension,OSAHS in male was higher （6.1%, 4.9% and 4.2% respectively）than female （4.6%, 3.3% and 1.20/oo respec-tively,P〈0.05） ,while Cushing＇s syndrome and anxiety showed a higher incidence in female （0.9% and 2.4%） than male （0. 3% and 1.4% ,P〈0.05）. The incidence of renal hypertension（including renal parenchymal hyper-tension and renovascular hypertension）, endocrine hypertension or Cushing＇s syndrome was higher in youth than the middle-aged and the elderly patients （P〈0.05）, while the incidence of primary aldosteronism, pheochromocy-toma, or OSAHS was higher in young and the middle-aged patients than the elderly patients （P〈0.05）. The inci dence of renal hypertension, renal parenchymal hypertension,renovascular hypertension was higher in patients of Uygur and Kazak nationalities than Han nationality （P〈0. 05）. Higher incidence of primary aldosteronism and lower incidence of OSAHS were found in patients of Han nationality than Uyghur nationality （P〈0.05）. Hyper-tension induced by pheochromocytoma or anxiety was more common in patients of Kazak compared to that of the patients of Uyghur and Han nationalities（P〈0.05）. ③ Main etiological factor of renovascular hypertension was atherosclerosis. Conclusion：①Essential hypertension is the main cause of high blood pressure. Incidence of SH is on the rise, Main etiology of SH is renal hypertension, followed by endocrine hypertension, OSAHS, and anxiety disorder. Primary aldosteronism constitutes the main cause of endocrine hypertension,and its incidence is on the rise. ②Etiology is different in different gender, nationality and age. ③Main etiological factor of renovascular hy-pertension is atherosclerosis.