80岁以上高龄老人血压变异性与尿微量白蛋白关系探讨

Relationship between blood pressure variability and microalbuminuria in elderly people 80years old and over

目的评价年龄≥80岁老人血压变异性(blood pressure variability,BPV)与尿微量白蛋白的关系。方法选择年龄≥80岁老人116例,按照尿微量白蛋白分为异常组(24h尿微量白蛋白≥30mg)55例和正常组(24h尿微量白蛋白<30mg)61例,比较并分析2组24h动态血压参数和BPV参数;Logistic回归分析尿微量白蛋白增高的危险因素。结果异常组踝臂指数(ankle brachial index,ABI)、24h平均舒张压(24h mean diastolic blood pressure,24hDBP)、昼间平均舒张压(day mean diastolic blood pressure,dDBP)低于正常组,异常组24h舒张压血压变异性(24hour diastolic blood pressure variability,24hDBPV)、昼间舒张压血压变异性(day diastolic blood pressure variability,dDBPV)高于正常组,差异有统计学意义。Logistic回归分析显示dDBPV、ABI为尿微量白蛋白增高的危险因素(P<0.05)。结论年龄≥80岁高龄老年人群24hDBP,dDBP,24hDBPV,dBPV与早期肾脏损伤相关,而dDBPV、ABI为早期肾脏损伤的危险因素。

Objective To investigate the relationship between blood pressure variability（BPV）and microalbuminuria in elderly people aged 80 years old and over.Methods A total of116 people aged 80 years old and over were divided into two groups according to the microalbuminuria：normal group（24hU-Alb30mg,n=61）or microalbuminuria group（24h U-Alb≥30 mg,n=55）.Comparison was made in 24 hdynamic blood pressure parameters and BPV parameters.Logistic regression analysis was used for risk factors of raised microalbuminuria.Results Ankle brachial index（ABI）,24 h mean diastolic blood pressure（24hDBP）,day mean diastolic blood pressure（dDBP）of microalbuminuria group were significantly lower than those of normal group（P〈0.05）,but 24 hDBPV,day mean diastolic blood pressure variability（dDBPV）of microalbuminuria group were significantly higher than those of normal group（P〈0.05）.Logistic regression analysis indicated that dDBPV and ABI were risks for raised microalbuminuria.Conclusion 24 hDBP,dDBP,24 hDBPV and dBPV related with early kidney impairment in elderly people aged 80 years old and over.dDBPV and ABI were independent risks for early kidney impairment.