维吾尔族健康人群肾功能与年龄及中心动脉压的关系

Relationship between the decline of age-related renal function and central aortic pressure in healthy Uygur population

目的 了解维吾尔族健康人群肾功能与年龄及中心动脉压（CAP）的关系.方法 于2009年7至8月从新疆和田地区,筛选临床健康居民638名,依据年龄分为4组（＜30岁、30～岁、45～岁、≥60岁）检测血压、血肌酐等指标,用中国人校正的MDRD公式估算的肾小球滤过率（eGFR）,用澳大利亚PWA仪测定CAP,主要包括中心收缩压（C-SBP）、中心脉压（C-PP）、增强压（AP）、增压指数（AIX）等组分.结果 随着年龄的增长,CAP和肱动脉压均呈增高的趋势,肾功能随增龄减退;肾功能及AP、AIX的增龄改变存在性别差异（P＜0.05）;在各年龄组中,女性的AP及AIX升高更为明显（P＜0.01）;高AIX人群比低AIX人群年龄偏大（52±12岁比44±13岁,P=0.000）,肾功能减退明显[eGFR（121±25）m1.min.（1.73 m2）-1比（131±33）ml.min.（1.73 m2）-1,P=0.000],且C-PP和AP增高明显（P=0.00）;多元回归分析显示eGFR和AIX呈负相关（P＜0.01）,与肱动脉压无关（P＞0.05）.结论 中心动脉压与肾功能的生理性衰退相关,在老年人群中进行中心动脉压监测,有助于筛选高危肾脏疾病人群,为临床探讨保护肾脏衰老的措施提供新的治疗理念和途径.

Objective To study the relationship between the decline of age-related renal function and central arterial pressure （CAP） in Uygur healthy population. Methods A total of 638 healthy Uygur inhabitants from Hetian region, Xinjiang province were enrolled. They were divided into 4 groups according to their ages. Their blood pressure, serum creatinine and other indicators were detected. eGFR （estimated glomerular filtration rate） was calculated by the formula of Chinese-based MDRD （Modification of Diet in Renal Disease）. CAP was measured by a pulse wave analyzer including central arterial systolic blood pressure （C-SBP）, central arterial pulse pressure （C-PP）, augmentation pressure （AP）, augmentation index （AIX） and other components. Results CAP and brachial arterial pressure tended to increase and renal function declined with age. There were gender differences in renal function. Both AP and AIX changed with age （ P 〈 0. 05 ）. In each group, AP and AIX increased even more significantly in females （ P 〈 0. 01 ）.The average age of subjects with a high AIX was 52 y ± 12 y. And it was elder than that of those with a low AIX （44 y ± 13 y, P =0. 000）. The renal function of those with a high AIX was lower than those with a low AIX [（121 ±25） ml. min. （1.73 m2） -1]vs （131 ±33） ml. min. （1.73 m2） -1, P=0. 000]. The levels of C-PP and AP were much higher in those with a high AIX （ P = 0. 00）. The results of multivariate analysis showed that eGFR was negatively correlated with the level of AIX （ P 〈 0. 01 ）. And it had no relationship with the brachial artery pressure （ P 〉 0. 05 ）. Conclusion Central arterial pressure is associated with the decline of age-related renal function. Monitoring of CAP may help to screen the high-risk patients in the elderly population. This study provides rationales for new therapeutics of protecting the aging of kidneys.