436例原发性高血压患者肾功能与动脉弹性关系探讨

Relationship between the level of renal function and large arterial elasticity in 436 patients with es- sential hypertension

目的探讨原发性高血压患者肾功能水平与大动脉弹性的关系。方法入选2009年10月～2011年10月北京安贞医院高血压科门诊及住院的原发性高血压患者436例，通过MDRD公式估算肾小球滤过率（GFR），评估肾功能，测定肱一踝动脉脉搏波传导速度（baPWV）作为评估大动脉弹性功能的指标。对全部高血压病患者的GFR与baPWV及其他影响因素进行相关分析及逐步回归分析，并对不同程度肾功能水平患者的baPWV值进行比较。结果入选的436例患者在检测前均未服用降压药物，年龄20—77岁。GFR水平与年龄、baPWV、收缩压、舒张压、脉压、尿酸水平呈负相关（P〈0．01），年龄、baPWV、尿酸进入最优回归方程。随着GFR的降低，baPWV明显增高（P〈0．01）。结论原发性高血压患者动脉僵硬度的增加与肾功能的减低关系密切。

Objective To investigate the relationship between the level of renal function and large arterial elasticity in patients with essential hypertension. Methods The patients with essential hy- pertension were enrolled from Anzhen Hospital hypertension outpatient and inpatient between October 2009 and October 2011. The glomerular filtration rate（GFR） was estimated by the MDRD formula to as- sess the renal function, and the brachial ankle arterial pulse wave velocity （baPWV） was measured as the indicator for assessment of arterial elasticity. The relationship between GFR and baPWV and other influen- cing factors in all patients with essential hypertension were evaluated with univariate analysis and stepwise regressive analysis, and baPWV values with varying degrees of renal function were compared. Results In- formation on clinical data were obtained from 436 patients （ all without medication）, aged from 20 to 77 years. GFR level was negatively correlated with age, baPWV, SBP, DBP, pulse pressure and UA （ P 〈 0.01 ）. The age, baPWVand UA were entered into the optimal regression equation. As eGFR decreases, baPWV was significantly higher（ P 〈 0.01 ）. Conclusion The increase in arterial stiffness is an signifi- cant factor for the reduction of renal function in patients with essential hypertension.