原发性高血压病人早期肾损伤影响因素的临床研究
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摘要
目的:探讨原发性高血压病人发生早期肾功能损伤的高危因素。方法:选取原发性高血压病人187例为研究对象,根据尿微量白蛋白/肌酐比值(UACR)分为单纯高血压组116例和高血压肾损组71例,比较2组病人一般临床资料及24 h、日间、夜间收缩压(SBP)和舒张压(DBP),分析原发性高血压病人发生早期肾功能损伤的危险因素。结果:单纯高血压组与高血压肾损组病人的性别、年龄、体质量指数和吸烟、饮酒差异均无统计学意义(P>0.05),单纯高血压组病人的病程明显短于高血压肾损组(P<0.01),在血压与血压变异方面,2组dSBP、dDBP、24 h SBP变异(24hSSD)、24 h DBP变异(24hDSD)、日间SBP变异(dSSD)、日间DBP变异(dDSD)差异均有统计学意义(P<0.05～P<0.01)。以UACR为因变量,以病程、dSBP、dDBP、24hSSD、24hDSD、dSSD、dDSD为自变量,进行多因素logistic回归分析,结果显示,病程、dSBP、24hSSD、24hDSD、dSSD、dDSD均为UACR的独立影响因素(P<0.01)。结论:原发性高血压病人病程、dSBP、24hSSD、24hDSD、dSSD、dDSD均为肾功能损伤的独立危险因素。
Objective:To study the risk factors of early renal damage in patients with primary hypertension.Methods:One hundred and eighty-seven patients with primary hypertension were divided into the hypertension group(116 cases) and hypertensive renal damage group(71 cases) according to the urine albumin/creatinine ratio(UACR),the clinical data,24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) between two groups were compared,and the risk factors of early renal damage in patients with primary hypertension were analyzed.Results:The differences of gender,age,body mass index,smoking and drinking between two groups were not statistically significant(P>0.05),the disease duration in hypertension group was significantly shorter than that in hypertensive renal damage group(P<0.01),and the differences of dSBP,dDBP,24 hSSD,24 hDSD,dSSD and dDSD between two groups were statistically significant(P<0.05 to P<0.01).The UACR was set as the dependent variable,the disease duration,dSBP,dDBP,24 hSSD,24 hDSD,dSSD and dDSD were set as the independent variable,and the multiple logistic regression analysis showed that the disease duration,dSBP,24 hSSD,24 hDSD,dSSD and dDSD were the independent influencing factors of UACR(P<0.01).Conclusions:The disease duration,dSBP,24 hSSD,24 hDSD,dSSD and dDSD are the independent risk factors of renal function damage in patients with primary hypertension.
Objective:To study the risk factors of early renal damage in patients with primary hypertension.Methods:One hundred and eighty-seven patients with primary hypertension were divided into the hypertension group(116 cases) and hypertensive renal damage group(71 cases) according to the urine albumin/creatinine ratio(UACR),the clinical data,24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) between two groups were compared,and the risk factors of early renal damage in patients with primary hypertension were analyzed.Results:The differences of gender,age,body mass index,smoking and drinking between two groups were not statistically significant(P>0.05),the disease duration in hypertension group was significantly shorter than that in hypertensive renal damage group(P<0.01),and the differences of dSBP,dDBP,24 hSSD,24 hDSD,dSSD and dDSD between two groups were statistically significant(P<0.05 to P<0.01).The UACR was set as the dependent variable,the disease duration,dSBP,dDBP,24 hSSD,24 hDSD,dSSD and dDSD were set as the independent variable,and the multiple logistic regression analysis showed that the disease duration,dSBP,24 hSSD,24 hDSD,dSSD and dDSD were the independent influencing factors of UACR(P<0.01).Conclusions:The disease duration,dSBP,24 hSSD,24 hDSD,dSSD and dDSD are the independent risk factors of renal function damage in patients with primary hypertension.
引文
[1]段跃兴,林仲秋,董凤英,等.不同血压评估参数与老年高血压病人靶器官损害的关系[J].山东医药,2017,57(17):53.
[2]刘力生.中国高血压防治指南[S].中华高血压病杂志,2011,19(8):703.
[3]郑琴,孙燕淑.动态动脉僵硬度指数与心血管疾病关系的研究进展[J].中国循环杂志,2017,32(4):414.
[4]杨斌武,张璐,韩冰,等.高血压合并冠心病病人血压变异性及其与靶器官损害的关系[J].中国老年学杂志,2017,37(14):3447.
[5]ROTHWELL PM,HOWARD SC,DOLAN E,et al.Prognostic significance of visit-to-visit variability,maximum systolic blood pressure,and episodiehypertension[J].Lancet,2010,375(9718):895.
[6]孙宁宁,董凤英,吴自强,等.老年H型高血压病人364例动态血压变异性及动脉硬化特点[J].广东医学,2017,38(7):1020.
[7]张磊,阮燕萍,魏万林,等.高血压病人脉搏波流速与血压及血压变异性指标的相关性分析[J].中国循证心血管医学杂志,2017,9(3):339.
[8]王雪琳,孙雅琴,汪家坤,等.补肾活血方治疗老年肾虚血瘀型原发性高血压病人的疗效及其对血压变异率和生活质量的影响[J].广西医科大学学报,2017,34(8):1134.
[9]高峰利,韩涛,张维,等.血压变异性与急性脑梗死合并H型高血压病人脑梗死严重程度及颈动脉内膜中膜厚度的关系研究[J].实用心脑肺血管病杂志,2017,25(8):45.
[10]刘骏,杜瑞雪,王亮,等.高血压病人血压变异性与5-10年复合心血管事件的关系[J].南方医科大学学报,2017,37(7):919.
[11]JAMES PA,OPARIL S,CARTER BL,et al.2014 evidence-based guideline for the management of high blood pressure in adults:report from the panel members appointed to the Eighth Joint National Committee(JNC 8)[J].JAMA,2014,311(5):507.
[12]张文君.动态血压监测在老年高血压合并靶器官损害中的应用价值[J].临床合理用药杂志,2017,10(19):25.
[13]叶明,李书国.衰弱表型与老老年病人血压的关系研究[J].实用心脑肺血管病杂志,2017,25(4):36.
[14]刘凌,刘锦全.血压变异性及血尿酸浓度联合预测急性心肌梗死冠脉病变严重程度及近期预后的价值[J].岭南心血管病杂志,2017,23(3):254.
[15]张海军.首次腔隙性梗死病人扩张的血管周围间隙与动态血压变异性分析[J].中国实用神经疾病杂志,2017,20(4):89.
[16]COLLIER DJ,POULTER NR,ASCOT Investigatons.Impact of amlodipine-based therapy among older and younger patients in the anglo-scandinavian cardiac outcomes trial blood pressure lowering arm(ASCOT-BPLA)[J].J Hypertens,2011,29(3):583.
[2]刘力生.中国高血压防治指南[S].中华高血压病杂志,2011,19(8):703.
[3]郑琴,孙燕淑.动态动脉僵硬度指数与心血管疾病关系的研究进展[J].中国循环杂志,2017,32(4):414.
[4]杨斌武,张璐,韩冰,等.高血压合并冠心病病人血压变异性及其与靶器官损害的关系[J].中国老年学杂志,2017,37(14):3447.
[5]ROTHWELL PM,HOWARD SC,DOLAN E,et al.Prognostic significance of visit-to-visit variability,maximum systolic blood pressure,and episodiehypertension[J].Lancet,2010,375(9718):895.
[6]孙宁宁,董凤英,吴自强,等.老年H型高血压病人364例动态血压变异性及动脉硬化特点[J].广东医学,2017,38(7):1020.
[7]张磊,阮燕萍,魏万林,等.高血压病人脉搏波流速与血压及血压变异性指标的相关性分析[J].中国循证心血管医学杂志,2017,9(3):339.
[8]王雪琳,孙雅琴,汪家坤,等.补肾活血方治疗老年肾虚血瘀型原发性高血压病人的疗效及其对血压变异率和生活质量的影响[J].广西医科大学学报,2017,34(8):1134.
[9]高峰利,韩涛,张维,等.血压变异性与急性脑梗死合并H型高血压病人脑梗死严重程度及颈动脉内膜中膜厚度的关系研究[J].实用心脑肺血管病杂志,2017,25(8):45.
[10]刘骏,杜瑞雪,王亮,等.高血压病人血压变异性与5-10年复合心血管事件的关系[J].南方医科大学学报,2017,37(7):919.
[11]JAMES PA,OPARIL S,CARTER BL,et al.2014 evidence-based guideline for the management of high blood pressure in adults:report from the panel members appointed to the Eighth Joint National Committee(JNC 8)[J].JAMA,2014,311(5):507.
[12]张文君.动态血压监测在老年高血压合并靶器官损害中的应用价值[J].临床合理用药杂志,2017,10(19):25.
[13]叶明,李书国.衰弱表型与老老年病人血压的关系研究[J].实用心脑肺血管病杂志,2017,25(4):36.
[14]刘凌,刘锦全.血压变异性及血尿酸浓度联合预测急性心肌梗死冠脉病变严重程度及近期预后的价值[J].岭南心血管病杂志,2017,23(3):254.
[15]张海军.首次腔隙性梗死病人扩张的血管周围间隙与动态血压变异性分析[J].中国实用神经疾病杂志,2017,20(4):89.
[16]COLLIER DJ,POULTER NR,ASCOT Investigatons.Impact of amlodipine-based therapy among older and younger patients in the anglo-scandinavian cardiac outcomes trial blood pressure lowering arm(ASCOT-BPLA)[J].J Hypertens,2011,29(3):583.