原发性高血压病患者大动脉僵硬度与肌酐清除率的相关性

Association between large arterial stiffness and creatinine clearance rate in patients with essential hypertension

目的探讨原发性高血压病患者主动脉脉搏波速度（pulse wave velocity,PWV）与肌酐清除率（creatinine clearance rate,Ccr）的相关性。方法应用脉搏波速度自动测量系统测量颈动脉-股动脉脉搏波速度（carotid-femoral PWV,CFPWV）,对644例血肌酐小于178mmol/L的原发性高血压患者（男340例,女304例,年龄18~82岁,平均52岁）进行脉搏波速度检测,并检测空腹血糖、血脂、肾功、尿酸等血生化指标,根据Cockcroft-Gault公式计算Ccr。结果 CFPWV在Ccr≥90 mL/min、90 mL/min〉Ccr≥60 mL/min和Ccr〈60 mL/min 3组间逐渐升高（P均〈0.01）,相关性分析显示CFPWV与Ccr呈显著负相关（P〈0.001）,Logistic回归分析得出CFPWV是影响高血压肾功能减退的独立因素。结论大动脉僵硬度增加与高血压早期肾功能减退相平行,可以反映高血压靶器官损害。

Objective To study the association between large arterial stiffness and creatinine clearance rate（Ccr） in patients with essential hypertension.Methods Automatic pulse wave velocity（PWV） measuring system was applied to examine carotid-femoral PWV（CFPWV） as the parameter reflecting aortic arterial stiffness.644 hypertensive patients aged 18~82 years（340 males and 304 females,mean age 52 years） with plasma creatinine178 mmol/L were recruited in the study.Ccr was estimated by using the Cockcroft-Gault formula.Results CFPWV increased gradually in patients with Ccr≥60 mL/min,90 mL/minCcr≥60 mL/min and Ccr60 mL/min（all P0.01）.CFPWV and Ccr were inversely and significantly correlated（P0.001）.A stepwise multiple regressive analysis demonstrated that CFPWV had significant independent influence on lower Ccr.Conclusion Increased arterial stiffness occur in parallel with the decline in renal function in patients with essential hypertension,and which could reflect target organ damage of hypertension.