老年原发性高血压病人脂代谢异常和肾功能相关研究

Correlation between abnormal lipid metabolism and renal function in aged patients with primary hypertension

目的探讨高脂血症对老年原发性高血压病人肾功能的影响。方法将200例65岁及以卜的老年原发性高血压病人根据既往有无高血脂病史分成正常组和高血脂组，比较两组病人血压、血糖、血脂及肾功能各项指标，并分析血脂和肾功能的关系。结果两组间血压、血糖差异没有统计学意义；高血脂组甘油三酯（TC）、胆固醇（TG）、低密度脂蛋白（LDL）、载脂蛋白B（ApoB）、尿素氮（Bun）、血清肌酐（Scr）、尿酸（UA）均高于正常组（P〈0．01）；相关分析表明：Bun和TC（r=O．3224，P=0．0009）、TG（r=0．3028，P=0．0052）、LDL（r=0．3985，P=0．0001）及ApoB（r=0．3145，P=O．0003）正相关；UA和TG正相关（r=O．3470，P=0．0001）；高密度脂蛋白（HDL）和Scr（r=-0．1875，P=0．0191）、UA和Scr（r＝-0．3173，P=0．0001）具有负相关，差异均有统计学意义。结论在血压、血糖相似的情况下，高脂血症是导致老年原发性高血压病人肾功能损害的重要因素。

Objective To evaluate the influence of hyperlipidemia on renal function in aged patients with primary hypertension. Methods Two-hundred male patients older than 65 years suffering from primary hypertension were randomized into two groups： the non hyperlipidemia （NHL） group and the HL group according to their history with or without HL. Blood pressure and serum biochemical indexes were compared. Correlation between hyperlipidemia and renal function was analyzed. Results There was no statistically significant difference in BP and FBS between the two groups, but TC, TG, LDL, ApoB, BUN, Scr and UA increased significantly in HL group compared with those in non HL group （P〈0.01）. BUN was positively correlated with TC （r=0.3224, P=0.0009）, TG （r=0.3028, P=0.0052）, LDL （r=0.3985, P=0.0001） and ApoB （r=0.3145, P=0.0003）, and UA was positively correlated with TG （r=0.3470, P=0.0001）. Negative correlation was observed between HDL and Scr （r=-0.1875, P=0.0191） and between UA and Scr （r=-0.3173, P=0.0001）. Conclusions Hyperlipidemia is an important factor affecting renal dysfunction in aged patients with primary hvpertension. when BP and glucose were controlled at the same level.