Isles C G, Lim K G, Boulton-Jones M, Cameron H, Lever A F, Murray G, Robertson J W
MRC Blood Pressure Unit, Western Infirmary, Glasgow, Scotland.
J Hypertens Suppl. 1985 Dec;3(3):S405-7.
In a study designed primarily to assess mortality, 139 consecutive patients presenting with malignant hypertension (MHT) in Glasgow between 1968 and 1983 were matched individually for age, sex and initial blood pressure with 139 non-malignant hypertensives attending the Glasgow Blood Pressure Clinic. Fifty-four patients with MHT and 34 controls died before 1 April 1984. Multivariate analysis showed that initial serum creatinine and blood pressure achieved during treatment were significantly and independently related to outcome among the patients with MHT, but that age, smoking habit, presence of papilloedema, underlying diagnosis, initial blood pressure and year of presentation were not. Overall survival among patients with MHT was 63% at 5 years and 47% at 10 years. Although this was better than in earlier studies patients with MHT were still twice as likely to die as non-malignant controls. The excess mortality was confined largely to patients with underlying renal disease and/or renal failure at presentation. Moreover, renal failure contributed to four times more deaths among patients with MHT than controls. Thus, despite an improvement in survival compared with previous years, renal failure remains the most serious manifestation of patients with this disease.
在一项主要旨在评估死亡率的研究中，1968年至1983年间在格拉斯哥连续出现恶性高血压（MHT）的139例患者，按照年龄、性别和初始血压与在格拉斯哥血压诊所就诊的139例非恶性高血压患者进行个体匹配。到1984年4月1日，54例MHT患者和34例对照死亡。多变量分析显示，MHT患者治疗期间达到的初始血清肌酐和血压与结局显著且独立相关，但年龄、吸烟习惯、视乳头水肿的存在、潜在诊断、初始血压和就诊年份则不然。MHT患者5年总生存率为63%，10年为47%。虽然这比早期研究要好，但MHT患者死亡的可能性仍是非恶性对照的两倍。额外的死亡率主要局限于就诊时患有潜在肾脏疾病和/或肾衰竭的患者。此外，肾衰竭导致MHT患者死亡的人数是对照的四倍。因此，尽管与前几年相比生存率有所提高，但肾衰竭仍然是这种疾病患者最严重的表现。
