作者：王应鹏，王归真，殷彩桥，杨燕，徐凤九，席芳娴

【关键词】  高血压；血脂；年龄；性别

   【Abstract】 AIM: To analyze the characteristics of blood fat of hypertensive patients in different age periods and of different sexes and to provide reference for the prevention and treatment of high blood pressure. METHODS: Hypertensive patients (n=629) were divided into 5 groups according to their ages at entering the hospital: Group A with 61 patients (≤50 years), Group B with 82 patients (51-60 years), Group C with 221 patients (61-70 years), Group D with 214 patients (71-80 years), and Group E with 51 patients (≥81 years). Each group was further divided into male group and female group, and blood fat levels were analyzed between males and females.RESULTS: ① The levels of cholesterol (TC) and lowdensity lipoprotein cholesterol (LDLC) went respectively up then down with the aging. The blood fat level was higher among females than males in each group. The male patients blood fat peak level appeared in Group B (51-60 years) and the female patients appeared in Group C (61-70 years). ② The levels of triglyceride (TG) and apolipoprotein B (apo B) were at first low and went up quickly and then down slowly. The levels were higher among males than females in Group A (≤50 years) and B (50-60 years), but were higher among females than males in Group C (61-70 years), D (71-80 years) and E (≥81 years). The male patients blood fat peak level also appeared in Group B（51-60 years）and the female patients appeared in Group C（61-70 years). ③ The levels of highdensity lipoprotein cholesterol（HDLC） and apolipoprotein A （apo A） changed little. Group C（61-70 years） had the male patients lowest blood fat level and the female patients blood fat peak level. The blood fat level was higher among females than males in each group. ④ When all of the patients were divided into male group and female group，the blood fat level was higher among females than males.CONCLUSION: The blood fat level of hypertensive patients shows variety according to different age, sexes, and components of blood fat. Generally, the blood fat level was higher among females than males. The peak level of males appears between 51 and 60 years and that of females appears between 61 and 70 years. The peak is 10 years later among females than males.

   【Keywords】 hypertension; blood lipid; age; sex

   【摘要】 目的：分析不同年龄与性别之间高血压病患者血脂特点，为高血压病患者的防治提供依据. 方法：629例高血压患者按入院时年龄大小分为5组: A组61例，≤50岁；B组82例，51～60岁；C组221例，61～70岁；D组214例，71～80岁；E组51例，≥81岁. 每组按性别分为男、女组，分析各组之间男女患者血脂特点. 结果：①胆固醇(TC)和低密度脂蛋白胆固醇(LDLC)的水平均表现为随年龄的增加先增加后下降的表现，每组血脂水平又均表现为女性高于男性，血脂水平高峰男性在51～60岁组，女性在61～70岁组. ②甘油三酯(TG)和载脂蛋白B(apo B)的水平均表现为先低然后很快增高，之后逐渐下降，在60岁以前的每组均表现为男性高于女性，60岁以后同样表现为女性高于男性，血脂水平高峰同样男性在51～60岁之间，女性在61～70岁之间. ③高密度脂蛋白胆固醇(HDLC)和载脂蛋白A(apo A)总体变化不大，但在61～70岁组男性最低，女性最高，每组血脂水平同样表现为女性高于男性. ④将全部高血压患者按男女两组之分，均表现为每个血脂水平女性高于男性. 结论：高血压病患者的血脂水平按年龄、性别及血脂成分表现有多样性. 总的表现为血脂水平女性高于男性；男性在51～60岁最高，女性在61～70岁最高；高峰水平女性较男性晚约10 a.

   【关键词】 高血压；血脂；年龄；性别

    0引言

   据统计，我国18岁及以上居民高血压患病率为18.8%，全国患者人数超过1.6亿. 有研究表明［1］,高血压组的胆固醇(TC),甘油三酯(TG)和低密度脂蛋白胆固醇(DLC)均明显高于正常血压组，而高密度脂蛋白胆固醇(HDLC)明显低于正常血压组. 同时［2］，TC，TG和血压水平随着年龄的增加而增加；且男性组明显高于女性组. 而高血压、血脂紊乱、年龄和性别均是心血管疾病的危险因素. 我们对629例高血压病患者按不同年龄和性别的血脂各水平进行分析，为高血压病患者的防治提供依据.

   1对象和方法

   1.1对象200001/200512我院收治患者629(男296，女333)例,根据中国高血压防治指南(试行本)标准确诊，除外继发性高血压. 年龄27～93岁, 高血压病史1～50 a. 其中,血压≤139/89 mmHg(1 mmHg=0.1333 kPa) 147例；高血压1级(140～159/90～99 mmHg) 213例；2级(160～179/100～109 mmHg) 175例, 3级(>180/110 mmHg) 94例. 同时患有冠心病345例，糖尿病85例;有高血压遗传史者87例.

   1.2方法所有患者于入院时平卧位测量2次血压，以Korotkoff第1音为收缩压，第4音为舒张压(无第4音时则以第5音为准). 于次日清晨抽取空服静脉血，TC，TG试剂盒及标准品由上海长征医学科学有限公司提供，HDLC一步方法试剂盒由卫生部上海生物制品研究所提供. 实验室分离血清备用，随机带室内质控(日本第一化学质控品). TC，TG，HDLC用酶法测定(单位：mmol/L). 低密度脂蛋白胆固醇(LDLC)用Friedwalds公式换算，即LDLC=TC－HDLC－TG/2.2，为消除TG值在>4.52时造成LDLC的偏差，所有乳糜血清样本结果未纳入本文统计. 载脂蛋白(apo A)和载脂蛋白B(apo B)用免疫透射比浊法测定，试剂盒由上海科华生物工程股份有限公司提供. 所有患者按年龄大小分为5组：A组61例，≤50岁；B组82例，51～60岁；C组221例，61～70岁；D组214例，71～80岁；E组51例，≥81岁. 每组按性别分为男和女，A组分别为35和26例；B组39和43例；C组89和132例；D组108和106例；E组25和26例. 总计男296例和女333例. 分别分析各组之间男女患者血脂特点.

   统计学处理：计量资料以x±s表示，组间差异比较方差齐者用成组t检验，方差不齐者用t′检验. 所有数据输入SPSS 10.0软件包处理. P<0.05为差异有统计学意义.

   2结果

   表1显示：①TC和LDLC的水平均表现为随年龄的增加先增加后下降的表现，每组血脂水平又均表现为女性高于男性，血脂水平高峰男性在51～60岁组，女性在61～70岁组. ②TG和apo B的水平均表现为先低然后很快增高，之后逐渐下降，在60岁以前每组均表现为男性高于女性，60岁以后同样表现为每组女性高于男性，血脂水平高峰同样男性在51～60岁之间，女性在61～70岁之间. ③HDLC和apo B总体变化不大，但在61～70岁组男性最低，女性最高，每组血脂水平同样表现为女性高于男性. ④将全部高血压病患者按男女两组之分，均表现为每个血脂水平女性高于男性(P<0.01). ⑤在61～70岁和71～80岁组中也均表现为血脂水平女性高于男性(P<0.05).表1不同年龄和性别组高血压病患者血脂差异

   3讨论

   高血压、血脂紊乱，年龄和性别均是心血管疾病的危险因素. 余海涛等［1］认为：TC，TG和LDLC在高血压组明显高于正常血压组，而HDLC则相反. 但