母系遗传性高血压发病年龄特征及相关危险因素分析

Age-of-onset distribution and risk factors related to maternally inherited essential hypertension

摘要:

目的 探讨母系遗传性高血压（MIEH）发病年龄的特征及其相关危险因素。方法 选择具有母系遗传特征的高血压家系[家系A（n＝104）和家系B（n＝19）]及散发高血压病例（n＝154），收集所有入选成员的人口统计学资料和高血压相关的临床资料。比较家系中不同传代的MIEH患者发病年龄；散发高血压病例中MIEH患者（n＝36）分别与非MIEH者（n＝118）及正常对照者（n＝36）的发病年龄、临床环境相关危险因素和生化指标进行比较分析。结果 在家系A的14例MIEH患者中，不同传代的高血压发病年龄分别为：第Ⅱ代（62.0±6.2）岁（n＝4），第Ⅲ代（46.3±5.8）岁（n＝6），第Ⅳ代（23.3±2.9）岁（n＝4）。家系B的6例MIEH患者中，不同传代的高血压发病年龄分别为：第Ⅰ代（58.0±0）岁（n＝1），第Ⅱ代（48.3±7.6）岁（n＝3），第Ⅲ代（37.5±0.7）岁（n＝2）。在散发高血压病例中，MIEH患者平均发病年龄低于非MIEH的高血压患者（P＜0.01）；MIEH患者与正常对照组体质量指数（P＜0.05）、腰臀比（P＜0.05）、饮酒（P＜0.05）、肌酐水平（P＜0.01）差异均有统计学意义。结论 MIEH具有早发和发病年龄逐代提前的特征；遗传因素可能与高血压临床环境相关危险因素共同作用参与MIEH的发病和发展过程。

Abstract:

Objective To investigate the feature of age-of-onset of maternally inherited essential hypertension (MIEH) and the relative risk factors. Methods Two hypertensive pedigrees with the characteristics of MIEH [pedigree A (n＝104) and pedigree B (n＝19)] and individual hypertensive cases (n＝154) were subjected in this study. Their demographic information and clinical data were collected. The age-of-onset, hypertension-associated environment, clinical risk factors and biochemical indices of MIEH (n＝36), non-MIEH (n＝118) patients and normal controls (n＝36) were compared. Results Among the 14 MIEH patients from the pedigree A, the age-of-onset was (62.0±6.2) years in generation Ⅱ (n＝4), (46.3±5.8) years in generation Ⅲ (n＝6), and (23.3±2.9) years in generation Ⅳ (n＝4). Among the 6 MIEH patients from the pedigree B, the age-of-onset was (58.0±0.0) years in generation Ⅰ (n＝1), (48.3±7.6) years in generation Ⅱ (n＝3), and (37.5±0.7) years in generation Ⅲ (n＝2). Among the individual hypertensive cases, the average age-of-onset of hypertension was lower in MIEH patients than in non-MIEH ones (P＜0.01). There were significant differences in body mass index (P＜0.05), waist to hip ratio (P＜0.05), alcohol intaking (P＜0.05) and creatinine level (P＜0.01) between MIEH and healthy volunteers. Conclusion A progressively early age-of-onset by generation is observed as the characteristics of MIEH. Hereditary factors, probably combining with the clinical risk factors, participate in the early onset of and progress in MIEH.