2025 年第 1 期 第 0 卷

骨髓增殖性肿瘤患者高血压患病的临床特征分析

Clinical characteristics of hypertension in patients with myeloproliferative neoplasms

作者：赵森  杨春  王旖旎

英文作者：Zhao Sen Yang Chun Wang Yini

单位：首都医科大学附属北京安贞医院血液科，北京100029

英文单位：Department of Hematology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：骨髓增殖性肿瘤；  真性红细胞增多症；  原发性血小板增多症；  高血压

英文关键词：Myeloproliferativeneoplasms;  Polycythemiavera;  Essentialthrombocythemia;  Hypertension

• 摘要：

• 目的  探索骨髓增殖性肿瘤（MPN）患者高血压患病的临床特征。方法  回顾性收集2010年5月至2020年5月首都医科大学附属北京安贞医院收治住院的103例MPN患者［包括真性红细胞增多症（PV）患者（PV组）61例和原发性血小板增多症（ET）患者（ET组）42例］的临床资料。统计PV组和ET组患者高血压患病率和年龄分布情况，比较2组中高血压患者的临床特征差异。结果  本研究中MPN患者总体的高血压患病率为52.4%（54/103），以55～64岁、75～84岁组高血压患病相对比例较高，分别为17例/27例、5例/7例；而25～44岁组高血压患者均为MPN继发性高血压。PV组高血压患者年龄明显小于、血小板计数水平低于ET组，男性比例、JAK2V617F基因突变率、男性和女性血肌酐水平、血红蛋白、红细胞压积均高于ET组（均P＜0.05）。相关性分析显示PV组中高血压患者的收缩压水平与白细胞计数呈正相关性，2组中高血压患者的左心室射血分数均与白细胞计数呈负相关性（r＝0.453，P=0.047；r＝-0.448，P=0.019；r＝-0.491，P=0.049）。PV组继发性高血压患者MPN病史长于，舒张压水平、男性和女性血肌酐水平、JAK2V617F基因突变率、血红蛋白和红细胞压积水平均明显高于ET组，血小板计数水平低于ET组（均P<0.05）。结论  MPN患者的高血压患病率高于总体人群，且呈现明显年轻化特征。PV和ET患者高血压患病具有不同的临床特点。

• Objective  To explore the clinical characteristics of hypertension in patients with myeloproliferative neoplasms (MPN). Methods   The clinical data of 103 MPN patients ［including 61 patients with polycythemia vera (PV group) and 42 patients with essential thrombocythemia (ET group)］ admitted to Beijing Anzhen Hospital, Capital Medical University from May 2010 to May 2020 were retrospectively collected. The prevalence of hypertension and age distribution of patients in PV group and ET group were analyzed, and the differences in clinical characteristics of hypertension patients in the two groups were compared. Results   In this study, the overall prevalence of hypertension in MPN patients was 52.4% (54/103), and the relative proportion of hypertension was relatively high in patients aged 55-64 years and 75-84 years, which were 17/27 and 5/7, respectively. However, the hypertension patients in the 25-44 years old group were all secondary hypertension in MPN. Patients with hypertension in PV group were younger and had lower platelet count than those in ET group. The proportion of male patients, JAK2V617F gene mutation rate, serum creatinine, hemoglobin and hematocrit in both men and women were higher in PV group than those in ET group (all P<0.05). Correlation analysis showed that systolic blood pressure was positively correlated with white blood cell count in hypertensive patients in PV group, and left ventricular ejection fraction was negatively correlated with white blood cell count in hypertensive patients in both groups (r=0.453, P=0.047; r=-0.448, P=0.019; r=-0.491, P=0.049). The history of MPN in secondary hypertension patients in PV group was longer than that in ET group. The diastolic blood pressure, serum creatinine in male and female, JAK2V617F gene mutation rate, hemoglobin and hematocrit in secondary hypertension patients in PV group were significantly higher than those in ET group, and the platelet count was lower than that in ET group (all P<0.05). Conclusion   The prevalence of hypertension in MPN patients is higher than that in the general population, and it is significantly younger. PV and ET patients have different clinical characteristics of hypertension.