实用心脑肺血管病杂志2026，Vol.34Issue(7)：19-24,6.DOI:10.12114/j.issn.1008-5971.2026.00.150
继发性高血压患者的病因构成及其发生难治性高血压的影响因素研究
Etiological Composition of Patients with Secondary Hypertension and the Influencing Factors of Refractory Hypertension
摘要
Abstract
Objective To investigate the etiological composition of patients with secondary hypertension and the influencing factors of refractory hypertension.Methods A total of 391 patients with secondary hypertension admitted to the Department of Hypertension of Renmin Hospital of Wuhan University from November 2024 to November 2025 were continuously selected as the research subjects.The clinical data of the patients were collected,and the patients were divided into refractory hypertension group(n=73)and non-refractory hypertension group(n=318)according to whether they conformed to the diagnostic criteria for refractory hypertension.Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of refractory hypertension in patients with secondary hypertension.Results The etiology of 391 patients with secondary hypertension was primary aldosteronism(PA)in 142 cases(36.32%),obstructive sleep apnea(OSA)in 123 cases(31.46%),renovascular hypertension in 46 cases(11.76%),renal parenchymal hypertension in 22 cases(5.63%),mixed etiologies in 21 cases(5.37%),and other causes in 37 cases(9.46%).The proportion of patients with heart failure,plasma aldosterone,angiotensin Ⅱ(AngⅡ),and serum uric acid in the refractory hypertension group were higher than those in the non-refractory hypertension group(P<0.05).There was a statistically significant difference in etiology between the two groups(P<0.05).Univariate Logistic regression analysis showed that heart failure,renin activity,serum creatinine,estimated glomerular filtration rate(eGFR),serum uric acid,and etiology may be influencing factors for refractory hypertension in patients with secondary hypertension(P<0.05).Multivariate Logistic regression analysis showed that heart failure,ARR,renin activity,serum uric acid,and etiology were independent influencing factors for refractory hypertension in patients with secondary hypertension(P<0.05).Conclusion PA and OSA are the predominant etiologies of patients with secondary hypertension.Heart failure,ARR,renin activity,serum uric acid,and etiology are independent influencing factors for refractory hypertension in patients with secondary hypertension.关键词
高血压/继发性高血压/难治性高血压/影响因素分析Key words
Hypertension/Secondary hypertension/Refractory hypertension/Root cause analysis分类
医药卫生引用本文复制引用
沈梦瑶,周晓阳..继发性高血压患者的病因构成及其发生难治性高血压的影响因素研究[J].实用心脑肺血管病杂志,2026,34(7):19-24,6.基金项目
国家自然科学基金资助项目(81970331) （81970331）
