年龄对老年高血压患者伴急性肾功能衰竭诱发多器官功能衰竭的预测价值

Predictive value of age and acute renal failure for multiple organ dysfunction syndrome in old patients with hypertension

目的分析年龄对老年高血压患者伴急性肾功能衰竭(ARF)后诱发多器官功能衰竭(MODSE)的影响,探讨年龄和ARF对老年高血压患者发生MODSE的预测价值。方法回顾性分析年龄≥60岁的高血压患者19 996例临床资料,以10岁为界分为60～69岁10 644例、70～79岁7427例、80～89岁1750例和≥90岁175例4个年龄段,再以69岁、79岁和89岁为分界点,分别分析4个年龄段及3个年龄分界点上下患者中,因ARF并发MODSE的发生率。结果所有ARF患者MODSE发生率较非ARF患者MODSE发生率明显升高(66.7%vs1.3%,P=0.00)。与60～69岁比较,≥90岁患者发生ARF的比例明显升高(2.8%vs 20.0%,P<0.05);4个年龄段伴ARF发生MODSE分别为51.4%、71.3%、84.9%、94.3%(P=0.00)。年龄与ARF和MODSE均呈正相关(r=1.00,P=0.000);排除年龄因素的影响后,偏相关分析表明,ARF与MODSE无相关性(r=-0.914,P=0.266)。结论年龄是老年高血压患者发生ARF及并发ARF后出现MODSE的重要影响因素。年龄对ARF诱发老年高血压患者发生MODSE具有一定的早期预测价值。

Objective To study the predictive value of age and acute renal failure（ARF） for occurrence of multiple organ dysfunction syndrome elderly（MODSE） in old patients with hypertension. Methods Medical histories of 19 996 cases of hypertension were analyzed retrospectively. According to age,they were divided into four groups： 60-69 years group;70-79 years group; 80-89 years group; 990 years group. The incidence of ARF and the morbidity of MODSE in- duced by ARF at different ages and different boundary ages were investigated. Results The inci- dence of MODSE in ARF cases was higher than that in the non-ARF cases（66.7% vs 1.3%, P = 0.00） ,showing that ARF was the important factor for induction of MODSE. The incidence of ARF was 2. 8%,4. 1%,6. 8% and 20. 0%（P 〈 0. 05） in 60--69 years group, 70--79 years group,80--89 years group and 990 years group respectively, the morbidity of MODSE was 51.4%,71.3%,84.9% and 94. 3% （P 〈 0.05） in the 4 age groups respectively. Occurrence of ARF and MODSE was positively correlated with age （r = 1.00 P = 0. 000）. Conclusion Age is valuable for early prediction of MODSE induced by ARF in old patients with hypertension.