目的：探讨睡眠障碍对老年单纯收缩期高血压晨峰的作用。方法：从本院2010年1月至2011年11月医治的老年单纯收缩期高血压病例中，抽样选取122例患者作为实验对象，即对照组61例患者无睡眠障碍，实验组61例患者合并睡眠障碍，运用动态血压检查对比两组患者的晨间血压。结果：实验组的收缩压是(183.4±11.0)mmHg，相比正常组的(161.2±14.8)mmHg，睡眠障碍患者的显著较高，差异比较有统计学意义（P＜0.05）。然而实验组的舒张压为(82.9±8.4)mmHg，相比正常的(80.3±7.7)mmHg，差异没有统计学意义（P＞0.05）。结论：积极改善老年单纯收缩期高血压患者的睡眠质量，对患者病情的治疗和改善是有着极其重要的作用和意义。

Objective:To study the effect analysis of sleep disorders in the morning peak of isolated systolic hypertension of the aged. Methods: 122 patients of the elderly isolated systolic hypertension patients, treated in our hospital between January 2010 and November 2011, were selected as the study objects. The control group included 61 patients without the sleep disorders. The experimental group included 61 patients with the sleep disorders. Detecting the morning blood pressure by dynamic blood pressure and comparing the two groups. Results:The systolic blood pressure of the experimental group was (183.4+11.0) mmHg, significantly higher in patients with sleep disorders compared with the normal group [(161.2+14.8) mmHg], and the difference had statistical significance (P 0.05). Conclusion:Actively improving the sleep quality in elderly patients with isolated systolic hypertension plays an extremely important role in the improvement of disease treating of patients.

目的 探讨单纯舒张期高血压(IDH)人群的血压转归和影响因素.方法 采用队列研究方法,以参加2006至2007年度开滦集团公司职工健康体检的101 510名职工中符合2005年世界卫生组织/国际高血压协会高血压治疗指南IDH诊断标准、既往无高血压病史、未服用抗高血压药物、无心脑血管疾病史的6778名职工作为观察队列.排除未参加2008至2009年度、2010至2011年度体检以及随访期间新发心脑血管疾病、服用降压药物者,最终纳入统计分析的职工共4 600例.观察2010至2011年度查体结束时IDH人群的血压转归情况.参照2006年中国人口统计学资料,采用直接法标化年龄和性别.采用多因素logistic逐步回归模型分析影响IDH人群转归的因素.结果 (1)随访(4.03 ±0.26)年后,IDH人群转归为正常血压、单纯收缩期高血压(ISH)、收缩期-舒张期双期高血压(SDH)的标准化转归率分别为51.4％、3.5％、18.3％.其中,男性分别为45.6％、3.6％、22.0％,女性分别为57.4％、3.3％、14.7％.(2)多因素logistic逐步回归模型分析显示:影响IDH转归为正常血压的因素为基线年龄小、舒张压低、体质指数低、尿酸低、体育锻炼、不饮酒(P＜0.01或0.05);影响IDH转归为ISH的因素为基线年龄大、收缩压高、高敏C反应蛋白高(P均＜0.01);影响IDH转归为SDH的因素为基线年龄大、收缩压高、喜盐(P＜0.01或0.05).结论 未经治疗的IDH人群可转归为正常血压、ISH和SDH,且转归为正常血压的比例很高.多种因素影响单纯舒张期高血压的血压转归.

Objective To explore the prevalence of isolated diastolic hypertension and associated cardiovascular risk and blood pressure changes during follow up.Methods This cohort study screened 101 510 participants who were employees of the Kailuan Group,a state-run coal mining company in 2006 and 2007.Among them,6 778 subjects were diagnosed with isolated diastolic hypertension (IDH).IDH subjects without history of cardiovascular disease and not treated with antihypertensive drugs were included in this analysis.Participants without health examination between 2008 to 2009 or 2010 to 2011 were excluded.A total of 4 600 participants were included in the final analysis.At the end of the third health examination,the conversion rate of different blood pressure turnover was calculated after standardizing age and gender according to demographic data of China in 2006.Multivariate logistic regression analysis was applied to analyze the risk factors of blood pressure turnover in IDH population.Results (1

目的探讨中青年超重和肥胖对高血压各亚型患病率的影响。方法选取2012年9月在我院进行体检的某单位职工为研究对象，分析其中具有完整身高、体重、血压测量资料和生化指标且未服用降压药物的共计300名研究对象的结果。比较中青年超重和肥胖对高血压各亚型患病率和血清同型半胱氨酸（Hcy）水平的影响。结果该单位员工的超重和肥胖率分别达到35%和10.33%，男性更高，30~49岁间是超重和肥胖的患病高峰。随着BMI水平增加，男性和女性的收缩压、舒张压均值和血Hcy水平逐渐升高，在超重和肥胖组中，血压的性别差异消失。肥胖组血Hcy的性别差异消失。该单位员工总体高血压患病率为16%，在超重和肥胖组中分别达到20%和45.16%,收缩期和舒张期联合高血压（SDH）和单纯舒张期高血压（IDH）患病率高于单纯收缩期高血压（ISH）。30~49岁的中青年人群高血压亚型以SDH和IDH为主。2/3以上的超重或肥胖合并SDH或IDH是分布在中青年人群。37.5%和42.85%的30~49岁肥胖者合并高Hcy血症。结论超重和肥胖人群中血压和同型半胱氨酸的性别差异消失，高血压亚型以SDH和IDH为主，大多数的超重或肥胖合并SDH或IDH发生在30~49岁的中青年，应重点针对这部分人群开展综合健康促进措施防治高血压和高同型半胱氨酸血症。

Objective To explore the effect of the young and middle-aged overweight and obesity on the prevalence of hypertension subtype. Methods We selected 300 subjects who had medical examination and without taking antihypertensive drugs in our hospital in Sep 2012, and analysed complete data containing height, weight, blood pressure measurements and biochemical parameters. Compared the effect of young and middle-aged overweight and obesity on the prevalence of hypertension subtypes and serum homocysteine (Hcy) levels. Results The overweight rate and obesity rate were 35% and 10.33%, respectively, and the male is higher. The peak prevalence of overweight and obesity in the age of 30 to 49. Male and female systolic blood pressure, diastolic blood pressure and mean blood Hcy levels were gradually increased with the increasing of BMI levels. In overweight and obesity group, gender differences disappeared in blood pressure. In obesity group, Hcy levels had no difference in different gender. The to

目的加强对高龄老年高血压的认识,提高高龄老年高血压的诊治水平。方法对89例≥80岁的老年高血压患者的临床资料进行回顾性分析。结果高龄老年高血压中单纯收缩期高血压多见;常见合并疾病包括冠心病,脑血管病和高尿酸血症;实验室检查结果和影像学检查提示易出现血脂异常,超敏C反应蛋白升高、尿酸升高,脑血管意外、心律失常、左室肥厚以及颈动脉斑块形成。结论高龄老年高血压患者更易发生心脑血管疾病,增加病死率;临床医生要加强对高龄老年高血压的重视程度,掌握高龄老年高血压的临床特点,积极适当的干预,从而降低致残率和致死率。

Objective To analyze senile patients with hypertension in order to improve the level of diagnosis and treat -ment .Methods Clinical data of 89 patients with hypertension and who were aged over 80 years were retrospectively analyzed . Results Isolated systolic hypertension was more common in senile patients with hypertension ,usually combined with coronary heart disease,cerebrovascular disease and hyperuricemia .Laboratory tests and imaging revealed that dyslipidemia ,high sensi-tive C reactive protein elevation ,cerebrovascular accident ,arrhythmia,left ventricular hypertrophy and carotid artery plaque were more prone to occur .Conclusion Senile patients with hypertension are more prone to suffer from cardiovascular and ce-rebrovascular diseases and thus increase mortality .Clinicians should pay close attention to senile patients with hypertension and master clinical characteristics of these patients .Positive and appropriate intervention may well reduce the morbidity and mortal -ity.

目的 探讨慢性肾脏病(CKD)患者中单纯收缩期高血压(ISH)与CKD分期的关系.方法 选择CKD患者626例,按血压类型分为:正常血压、单纯舒张期高血压(IDH)、ISH和双期高血压(SDH).观察4种血压亚型在CKD各期的百分比.结果 在CKD 1、2、3、4、5期,IDH患病率分别为9.1％、6.7％、2.9％、3.1％和4.1％;ISH患病率分别为0、9.2％、23.9％、28.6％和37.0％;SDH患病率分别为4.5％、8.4％、8.0％、17.3％和21.9％;血压控制率逐渐下降,分别为86.4％、75.6％、65.3％、51.0％和37.0％(P＜0.05);多因素回归分析结果显示,年龄、糖尿病和CKD分期为发生ISH的独立危险因子.与CKD 1～2期比较,CKD 3、4、5期发生ISH的OR值分别为2.388、2.697和5.980.结论 CKD患者肾功能受损的的程度与ISH进展一致.

Objective To investigate the relationship between the prevalence of isolated systolic hypertension (ISH) and the stages of chronic kidney disease (CKD) in chronic kidney disease outpatient clinic.Methods CKD patients of stages 1,2,3,4 and 5 were recruited (n=626).Based on office systolic pressure (SBP) and diastolic pressure (DBP),they were classified into four subtypes:normotension (＜ 140/90 mmHg),isolated diastolic hypertension (IDH,SBP ＜ 140 mmHg and DBP ≥ 90 mmHg),ISH (SBP≥ 140 mmHg and DBP ＜ 90 mmHg) and systolic-diastolic hypertension (SDH,SBP≥140 mmHg and DBP≥90 mmHg).Results The control rate of blood pressure was 86.4％,75.6％,65.3％,51.0％ and 37.0％ at CKD stage 1,2,3,4 and 5,respectively,which decreased with the advancement of CKD.There was a stepwise increase in the prevalence of ISH (0,9.2％,23.9％,28.6％ and 37.0％ at CKD stage 1,2,3,4 and 5,respectively) and SDH (4.5％,8.4％,8.0％,17.3％,21.9％ at CKD stage 1,2,3,4 and 5,respectively).Logistic regression