继发性高血压论文：继发性高血压的病因分析.doc

继发性高血压论文：继发性高血压的病因分析【中文摘要】通过对继发性高血压病因的分析而进一步了解继发性高血压病因构成比,并与国内外的研究进行比较与分析,期望本研究能对临床实践有一定启发,并尽量减少继发性高血压的漏诊与误诊率。方法：采用回顾性研究方法,分析河南省人民医院高血压科自2009年7月至2010年6月共925份病历,从中筛选出继发性高血压病历共284例,筛选标准按目前国际(或国内)统一标准(若无统一标准,在文中将作出说明),并进行填表,包括年龄、性别、职业、生化检查及影像学等的结果,最后进行统计学分析。结果：在该科中,继发性高血压病因构成比如下：常见原因为：(1)精神因素共93例,其中广泛性焦虑58例；(2)睡眠呼吸暂停综合征54例；(3)肾血管性高血压39例；(4)混合性37例；(5)原发性醛固酮增多症34例；以上常见病因共占90.1%；不常见的病因包括肾实质性高血压10例、嗜铬细胞瘤5例、先天性主动脉缩窄2例、间脑癫痫1例以及真性红细胞增多症1例等,共占9.9%。结论：(1)在该科中,继发性高血压的病因构成比与国内外均有一定差别,与国内相比,常见病因有所不同,与国外相比,病因更加多样化；(2)继发性高血压病因中精神因素作为新增项并占据了第一位,共93例,其中广泛性焦虑最多,共58例；(3)在病因分类中,出现了“混合性”病因,包括两种或两种以上的继发性病因,并且跻身于常见病因之列;(4)在该研究中还收集到间脑癫痫病例1例,较为特殊,在国内外的继发性高血压病因中均未提及。【英文摘要】:To learn about the constituent ratios of causes of the Secondary Hypertension(HT), and compare it with the similar studies in born and abroad, and anticipate it has some meanings for clinical practice to decrease the misdiagnosis.Methods:From June 2009 to Sept.2010,925 cases were selected out from the Hypertension Department of Henan Province Peoples Hospital, and 284 cases are secondary HT, whose constituent ratios were analyzed retrospectively. There we use the international(or domestic) standards as the screening criteria, and fill in the forms, including sex, age, career, Biochemical test results, imaging results,etc. And at last statistical analysis is used for these resultsResults:In our department,the causes constituent ratios of secondary HT are as follows: common secondary causes:(1) Psychological factors,93 cases, including 58 patients with the generalized anxiety disorder; (2) sleep apnea syndrome(SAS,54cases); (3)renovascular hypertension(39cases);(4)mixed causes of secondary HT(37 cases); (5) primary aldosteronism (PA,34 cases); account for around 90.1%; Uncommon secondary causes include renal parenchymal disease(10 cases), pheochromocytoma(5 cases), congenital aortic coarctation(2 cases), Diencephalic epilepsy(1 case), Polycythemia Vera(1 case),etc. nearly about 9.9%.Conclusions:(1)In our department, the causes constituent ratios of secondary HT are different from them both in China and in abroad, concretely, compared with the studies in China,the common causes are different, compared with the foreign studies, our uncommon causes are more diversified;(2) In the common causes, psychological factors, as a newly added item, has become the first one, accounted for 93 cases, and most of them are generalized anxiety disorders;(3) There is a new concept in the common causesmixed type, which includes two or more secondary causes in HT;(4) In this study,we also have one particular case of Diencephalic epilepsy, because it has not been metioned in the studies either in China or abroad.【关键词】继发性高血压 回顾性研究 病因分析【英文关键词】secondary HT Retrospective study analysis for the causes【目录】继发性高血压的病因分析英汉缩略语名词对照6-8摘要8-10ABSTRACT10-11前言12-14一、资料与方法14-221、资料142、入选标准143、诊断标准14-214、统计学处理21-22二、结果22-291、继发性高血压病因的构成比22-242、精神因素构成比及患者的职业特点24-263、睡眠呼吸暂停综合征(SAS)患者的特点分析26-274 原发性醛固酮增多症(PA)27-29三、讨论29-411、继