原发性高血压合并慢性肾脏病的危险因素分析

The prevalence and risk factors of essential hypertension with chronic kidney disease

目的：探讨新疆乌鲁木齐市原发性高血压（EH）住院患者中慢性肾脏病（CKD）的患病情况的及危险因素的分析。方法：回顾性的分析2011年3月至2012年2月在新疆医科大学第一附属医院高血压科住院确诊的982例EH患者合并CKD中患病情况及危险因素。结果：（1）EH患者合并蛋白尿、估算的肾小球滤过率（eGFR）下降、CKD患者构成比分别为20.3%、5.2%、23.5%，男性和女性EH中CKD构成比为（26.6% vs 20.2%），差异有统计学意义；汉族和维族EH合并CKD的构成比为（22.7％vs 26.0%），差异均无统计学意义。（2）收缩压每升高20mmHg，CKD的构成比明显增加，差异有统计学意义。（3）多因素Logistic回归分析表明：收缩压≥140mmHg（OR=1.503，95%CI 1.021-2.212）、糖尿病病史（OR=1.661，95%CI 1.174-2.351）、高尿酸血症（OR=1.691，95%CI 1.194-2.395）是EH合并CKD的独立危险因素。结论：控制血压、血糖和血尿酸水平可减少EH合并CKD的发生和发展。

Objective： To investigate the prevalence and the risk factors of essential hypertension （EH） in inpatients with CKD in Urumqi, Xinjiang. Methodology： Nine hundred and eighty-two EH inpatients were enrolled between March 2011 and February 2012 in hypertension department of the First Affiliated Hospital of Xinjiang Medical University in this retrospective study. The univariate and multivariate logistic regression were performed performed to analyze the risk factors of EH with CKD. Results： （1） In 982 cases of EH inpatients, the prevalence of proteinuria, reduced eGFR and CKD was 20.3%, 5.2% and 23.5%, respectively. The CKD （26.6% vs 20.2%） were more prevalent in male than that in female, there were significant differences in prevalence between them. The reduced eGFR （4.3% vs 6.2%） was more prevalent in female than that in male, but there was no significant difference. The EH with proteinuria （19.5% vs 22.7%）, reduced eGFR （4.9% vs 6.2%） and CKD （22.7% vs 26.0%） were more prevalent in Uygur than that in Han, but there were no significant differences. （2）The prevalence of CKD was significant increase for systolic blood pressure for each additional 20mmHg. （3）Logistic regression analysis showed： SBP≥140mmHg （OR=1.503, 95%CI 1.021~2.212）, diabetes （OR=1.661, 95%CI 1.174~2.351）, hyperuricemia （OR=1.691, 95%CI 1.194~2.395） was independent risk factors of EH with CKD. Conclusion： EH with CKD was associated with systolic blood pressure, diabetes, and hyperuricemia. To control blood pressure, glucoseand and uric can reduce the occurrence and development of CKD.