摘要
目的：探讨原发性高血压患者肱动脉脉压与肾小球滤过率（glomerular filtration rate,GFR）的相关性关系.方法：连续入选初诊的中青年（30～65岁）原发性高血压病患者318例,平均年龄（47.9±7.1）岁,测量右上臂肱动脉的收缩压和舒张压并计算肱动脉脉压作为观察组,同期选择年龄匹配的430例血压正常人群,平均年龄（47.9±8.5）岁,作为对照组,收集两组患者的临床和实验室检查资料.根据MDRD公式计算患者的GFR（eGFR）,按照数值分布的三分位点分别将观察组患者分为A、B、C三组,同法将对照组患者分为a、b、c三组.结果：随着分组eGFR的降低,观察组患者的年龄、肱动脉脉压及血清肌酐均呈明显增高趋势（P＜0.05）;而舒张压在组间比较呈明显降低趋势（P＜0.05）.对照组患者的年龄、肱动脉收缩压、平均动脉压、TG、TC、SCr均呈明显增高趋势（P＜0.05）;而肱动脉脉压在组间比较差异无统计学意义.针对观察组和对照组分别做相关和多元线性回归分析,结果显示：eGFR与观察组患者年龄、肱动脉脉压、SCr、UA呈显著负相关（r=-0.124,-0.150,-0.753,-0.131,P＜0.05）,而与肱动脉舒张压、HDL-C呈显著正相关（r=0.125,0.097,P＜0.05）;eGFR与对照组患者年龄、SCr、TC、TG、ALT呈显著负相关（r=-0.440,-0.749,-0.226,-0.178,-0.121,P＜0.05）,与肱动脉脉压无相关性.结论：相对于血压正常人群,中青年高血压病患者肱动脉脉压与eGFR呈负相关,是eG-FR的独立影响因素.
Objective：To investigate the relationship between brachial arterial pulse pressure（PP） and estimated glomerular filtration rate （eGFR） in young and middle-aged patients with essential hypertension. Methods：A total of 318 untreated young and middle-aged hypertensives, average age （47.9 ± 7.1 ） years, were consecutively recruited as observation group. Meanwhile 430 age-matched normotensive cases from medical examination center, average age （47.9 ± 8. 5 ） years, were as comparison group. Blood pressure of brachial artery were measured during screening, clinical and laboratory examination information were also collected. All cases＇ eGFR were calculated using the MDRD formula. And according to eGFR distribution tertile points, we divided the observation group into sub-group A, B and C; and the comparison group was divided into sub-group a, b and c. Results：With the decline of eGFR, the observation group＇s age, PP, and serum ereatinine were increasing progressively from subgroup A to subgroup C （ P 〈 0. 05 - 0. 01 ） ; diastolic pressure was decreasing gradually from subgroup A to subgroup C （ P 〈 0. 05 ）. The control group＇ s age, systolic pressure, mean arterial pressure, triglyceride, total cholesterol, serum creatinine were increasing progressively from subgroup a to subgroup e （ P 〈 0. 05 - 0. 01 ） ; but PP had no significant difference among the groups. Muhivariable linear correlation and regression showed that： in observation group, eGFR was significantly and negatively correlated with age, PP, serum ereatinine and serum uric acid （r = - 0. 124, -0. 150, - 0. 753, - 0. 131, P 〈 0. 05 0. 01 ） , eGFR was significantly and positively correlated with diastolic pressure and HDL-C （ r = 0. 125,0. 097, P 〈 0. 05 ） ; in comparison group, eGFR was significantly and negatively correlated with age, serum creatinine, total cholesterol, triglyeerides and ALT（ r = - 0. 440, - 0. 749, - 0. 226, - 0. 178, - 0. 121, P 〈 0. 05 0. 01 ）, while PP had no significantly correlation. Conclusion：In young and middle-aged hypertensives, compared with normotensives, brachial PP is significantly and negatively correlated with eGFR, and it is an independent influential factor to eGFR.
出处
《心肺血管病杂志》
CAS
2014年第6期825-829,共5页
Journal of Cardiovascular and Pulmonary Diseases
关键词
高血压
脉压
动脉僵硬度
肾小球滤过率
Hypertension
Pulse Pressure
Arterial stiffness
Glomerular Filtration Rate
