目的 了解难治性高血压患者在不同性别及年龄中的病因构成.方法 采用回顾性研究方法,分析2001年9月至2008年12月在我院内科住院的608例难治性高血压患者的病因分类及在不同性别和年龄段中的分布情况.结果 608例难治性高血压患者中原发性高血压占79.4%(483/608),继发性高血压占19.7%(120/608),病因待定者与0.8%(6/608);在难治性高血压患者中男惟多于女性,原发性高血压、继发性高血压、肾实质性高血压、睡眠呼吸暂停综合征、原发性醛固酮增多症男性所占的比例都高于女性;嗜铬细胞瘤女性比例高于男性;肾血管性高血压男女比例相同.继发性难治性高血压在青年中所占比例最大(33.9%),老年人中所占比例最小(13.8%).结论 本组难治性高血压患者中,原发性高血压所占比例最高;在继发性高血压中,肾血管性高血压和呼吸暂停综合征所占比例较高;内分泌性高血雎中,原发性醛固酮增多症所占比例最高;青年患者所占比例显著大于老年人.%Objectives To investigate the etiologic factors of intractable hypertension with different genders and ages. Methods Totally 608 cases of intractable hypertension with different genders and ages between Septem-ber 2001 and December 2008 were reviewed. Results Primary hypertension accounted for 79.4% (483/608),secondary hypertension was 19.7% (120/608) and uncertain etiology was 0.8% (5/608). Male was much more than female. Furthemore, the proportion of male was also higher than that of female in primary hypertension, renal parenchymal hypertension, sleep apnea syndromes and primary aldosteronism. The proportion of female was much more than male in pheochromocytoma. There was no gender difference in renovascular hypertension. In secondary intractable hypertension, the youth showed the largest proportion (33.9%) and the elderly people accounted for smallest proportion (13.8%). Conclusions In the 608 cases, primary hypertension has the highest proportion. In secondary hypertension, renal parenchymal hypertension and sleep apnea syndromes have a high proportion. In en-docrinic hypertension, primary aldosteronism and young patients have the highest proportion.
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