老年收缩期高血压大动脉僵硬度与年龄对肾功能叠加作用的初步观察

Effects of combined arterial stiffness and age on renal function in the elderly patient with isolated systolic hypertension

目的探讨收缩期高血压患者大动脉僵硬度与年龄对肾小球滤过率（GFR）的影响。方法选择在我院住院的老年单纯收缩期高血压（ISH）患者50例为观察组，同期年龄配对的健康老年人28名为老年对照组，健康中年人49名为中年对照组。采用方差分析比较3组主动脉脉搏波传导速度（baPWV）、GFR、收缩压（SBP）、舒张压（DBP）、脉压（PP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、三酰甘油（TG）、血糖、血肌酐。以GFR为因变量，年龄、baPWV、SBP、PP、TC、LDL-C、HDL-C、TG为自变量，进行多重线性回归分析。结果观察组、老年对照组、中年对照组aPWV依次降低，而GFR依次升高。采用协方差分析法调整了SBP、PP对GFR的影响后，观察组Gnt仍低于对照组。在多重线性回归方程中，以GFR为因变量，自变量贡献率依次为年龄、baPWV、SBP、PP。结论老年收缩期高血压患者大动脉僵硬度与年龄对GFR影响有叠加作用。

Objective To investigate the effect of combined arterial stiffness and age on glomerular filtration rate （GFR） in the elderly patient with isolated systolic hypertension. Methods Fifty eld- erly patients with isolated systolic hypertension （ISH） served as observation group, 28 healthy elderly subjects as older control group and 49 middle-aged healthy subjects as middle-aged group. Braehial-an- kle pulse wave velocity （baPWV）, glomerular filtration rate, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, pulse pressure （PP）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, triglycerides （TG）, fasting plasma glucose （FPG） and serum creatinine were compared among three groups. Results Among observation group, older control group and middle-aged group, baPWV was decreased in turn, while GFR was increased in turn. After adjusting for SBP and PP, GFR was similarly decreased in observation group than in control groups. In a multivariate linear regression, GFR was independently predicted by baP- WV, age, SBP, PP. Conclusions In patients with isolated systolic hypertension, baPWV and age both contribute to decreased GFIL