本文關(guān)鍵詞：高血壓合并代謝紊亂及對心腎血管的影響，，由筆耕文化傳播整理發(fā)布。

·894·中華高血壓雜志2006年11月第14卷第11期　ChinJHypertension,Nov2006,Vol.14No11

·論著·

高血壓合并代謝紊亂及對心腎血管的影響

徐興森,楊萬濤,劉道燕,鐘健,田志強(qiáng),閆振成,倪銀星,陳靜,趙志鋼,祝之明

　　【摘要】　目的　觀察高血壓合并代謝紊亂的狀況及其對心腎血管的影響。方法1211111111住院高血壓患者1033例

分為單純高血壓組102例、高血壓合并血脂紊亂組117例、高血壓合并腹型肥胖組119例、高血壓合并糖尿病組

135例和高血壓合并代謝綜合征組(MS)560例。應(yīng)用彩色多普勒超聲檢測心臟和血管的結(jié)構(gòu)和功能,應(yīng)用免疫

比濁法測定微量白蛋白尿(MAU),評估心腎血管損害情況。結(jié)果(1)住院病人中單純高血壓僅為9.9%,

90.1%的高血壓患者合并有代謝紊亂。(2)高血壓合并腹型肥胖時左室質(zhì)量(LVM)和左室質(zhì)量指數(shù)(LVMI)顯

著高于高血壓合并血脂紊亂組、高血壓合并糖尿病組和高血壓合并MS組(P<0.05或P<0.01)。高血壓合并

糖尿病組及高血壓合并MS組的頸動脈斑塊檢出率分別為65.7%和58.5%,明顯高于高血壓合并血脂紊亂組

(35.0%)和高血壓合并腹型肥胖組(45.8%)(P<0.05或P<0.01);高血壓合并糖尿病組及高血壓合并MS組

的MAU陽性率(分別為48.0%和41.8%)顯著高于單純高血壓組(9.5%)、高血壓合并血脂紊亂組(25%)和高

血壓合并腹型肥胖組(22.4%)(P<0.05或P<0.01)。結(jié)論

紊亂對高血壓的治療有重要意義。

　　【關(guān)鍵詞】　高血壓;　代謝因素;　靶器官損害

CardiovascularandRenalDamageinHypertensivesComplicatedwithMetabolicDisorders　XUXing-sen,YANG

Wan-tao,LIUDao-yan,ZHONGJian,TIANZhi-qiang,YANZheng-cheng,NIYin-xing,CHENJing,

ZHAOZhi-gang,ZHUZhi-ming.　CenterforHypertensionandMetabolicDisease,ThirdMilitaryMedical

University,DepartmentofHypertensionandEndocrinology,DapingHospital,ChongqingHypertensionIn-

stitute,Chongqing400042,China;Correspondenceauthor:ZhuZhi-ming,E-mail:zhuzm@

　　【Abstract】　Objective　Tostudythetargetorgandamageinpatientsofhypertensionwithmetabolicdisor-

der.　Methods　1033patientsweredividedintofivegroups:hypertensionwithoutcomplications(102cases),hy-

pertensionwithdyslipidemia(117cases),hypertensionwithabdominalobesity(119cases),hypertensionwith

type2diabetesmellitus(135cases),hypertensionwithmetabolicsyndrome(560cases).　Thestructureandthe

functionofheartandbloodvesselwereexaminedbycolorDoppler.　Urinarymicroalbuminuriawasdetermined.Results　(1)Only9.9%patientsofhypertensionwerewithoutmetabolicdisorder,90.1%hypertensivescompli-

catedwiththemetabolicdisorder;(2)Comparedwithhypertensionwithdyslipidemia,hypertensionwithtype2di-

abetesmellitus(P<0.05)andwithmetabolicsyndrome(P<0.01),patientswithabdominalobesityhadsignifi-

cantlygreaterleftventricularmass(LVM)andleftventricularmassindex(LVMI).　Comparedwithhyperten-

sionwithdyslipidemiaandhypertensionwithabdominalobesity,thepositiveratesofcarotidarteryplaquewere

significantlyhigherinhypertensionwithdiabetesmellitus(P<0.05)andhypertensionwithmetabolicsyndrome

(P<0.01).　Theincidencerateofabnormalmicroalbuminuria(MAU)wassignificantlyhigherinhypertension

withdiabetesmellitus(48.0%)andhypertensionwithmetabolicsyndrome(41.8%)(P<0.05orP<0.01).　

Conclusion　Mostclinicalhypertension(>90%)complicatedwiththemetabolicdisturbance.　Hypertension

complicatedwithabdominalobesityaccentuateleftventricularhypertrophy.　Hypertensionwithdiabetesmellitus

andmetabolicsyndromeaccentuatedthevascularandrenallesion.

　　【Keywords】　Hypertension;　Metabolicfactor;　Targetorgandamage

　　收稿日期:2006-06-14

基金項目:全軍十一·五攻關(guān)課題,項目編號06G070

　　作者單位:1.第三軍醫(yī)大學(xué)全軍高血壓代謝病中心,大坪醫(yī)院野戰(zhàn)外科研究所高血壓內(nèi)分泌科,重慶市高血壓研究所,重慶400042;2.武,,()超過90%的高血壓住院患者合并有不同形式的代謝紊亂,高血壓合并腹型肥胖將加重左室肥厚(LVH),合并糖尿病和MS加重大血管及微血管的損害,糾正代謝

  本文關(guān)鍵詞：高血壓合并代謝紊亂及對心腎血管的影響，由筆耕文化傳播整理發(fā)布。