老年高血压病患者良性小动脉性肾硬化症危险因素分析

A Study on Risk Factors of Benign Arteriolar Nephrosclerosis in Elderly Patients with Essential Hypertension

目的:探讨60岁以上高血压病患者发生良性小动脉性肾硬化症(BAN)的危险因素。方法:以国内公认的诊断标准,将339例高血压病患者分为BAN组89例和对照组250例。采用病例对照研究方法,对研究对象进行单因素及多因素Logistic回归分析。结果:经单因素筛选,有18个因素与BAN有关。多因素Logistic分析,有8个因素在P=0.05水平被选入模型中,即年龄(OR=1.408)、男性(OR=3.707)、吸烟(OR=3.429)、高血压病程(OR=1.153)、脉压(OR=1.137)、尿酸(OR=1.031)、低密度脂蛋白胆固醇(LDL-C,OR=4.160)和高密度脂蛋白胆固醇(HDL-C,OR=0.014)。结论:男性、高龄、吸烟、高血压病程、脉压、尿酸和LDL-C是BAN的独立危险因素,HDL-C是BAN的独立保护因素。

Objective： To investigate the risk factors of benign arteriolar nephrosclerosis （BAN） in elderly patients （age 〉 60 years） with essential hypertension. Methods-A case-control study was conducted in 89 patients with BAN which was due to essential hypertension. The control group was 250 cases with hypertension without BAN. Available data were analyzed by mono-factorial and multi-factorial Logistic regression methods using SAS 8.1 software. Results： Eighteen factors related to BAN were identified by the mono-factorial analysis. Eight factors were selected through multiple factorial Logistic regression model at P = 0.05 level. The independent risk factors on BAN were ： age （OR =1.408 ）, male gender （OR = 3.707 ）, smoking （ OR = 3.429 ）, courses of hypertension （ OR = 1.153 ）, pulse pressure （ OR = 1.137 ）, uric acid （ OR = 1.031 ） and LDL-C （OR = 4.160）. The independent protective factor of BAN was high density lipoprotein cholesterol （HDL-C,OR = 0.014）. Conclusion：The elderly male is the high-risk population in BAN. It is long course of hypertension, smoking, high pulse pressure, and high urine acid （UA）, high LDL-C and low HDL-C that may increase the risk of BAN.