长时和短时收缩压变异性指标与老年人群肾脏损害的关联研究

Relationship Between Long-,Short-term Systolic Blood Pressure Variability and Renal Damage in Elder Population

目的:探讨长时和短时收缩压变异性指标与老年人群肾脏损害的关联。方法:在参加开滦研究队列第三次健康体检的人群中,采取整群抽样的方法按照25%比例随机抽取年龄≥60岁的开滦集团离退休员工进行24小时动态血压监测等检查。在随机抽取的3 064例观察对象中,符合入选标准的为2 464例。收缩压变异性(SBPV)采用标准差(SSD)、独立变异性(VIM)、极差(MMD)和平均真实变异性(ARV)四种指标;肾脏损害采用肾小球滤过率(eGFR)、尿微量白蛋白(ALBU)两种指标。采用逐步线性回归方法,分析不同长时和短时SBPV指标与eGFR、ALBU的关联。结果:(1)在2 464例观察对象中,年龄平均为(67.41±6.05)岁。其中,男性1 667例(67.7%),女性797例(32.3%)。(2)在逐步线性回归分析中,不同长时SBPV指标均与eGFR、ALBU无线性相关;四项24h SBPV指标、三项日间SBPV指标(SSD、MMD、ARV)均与eGFR呈负线性相关,24 h ARV、日间MMD、日间ARV均与ALBU呈正线性相关,夜间SBPV指标均与eGFR、ALBU无线性相关。结论:不同短时收缩压变异性指标与eGFR、ALBU均存在一定程度的关联。

Objective： To investigate the relationship between long-, short-term systolic blood pressure variability（SBPV） and renal damage in elder population.Methods： Our research was conducted in the 3^rd physical examination of healthy population from Kailuan group by cohort study. Cluster sampling was used by 25% ratio in subjects≥60 years of age to monitor their 24-hour ambulatory blood pressure and finally, 2464/3064 participants with inclusion criteria were recruited. SBPV indexes as standard deviation of systolic blood pressure（SSD）, variability independent of the mean（VIM）, maximum-minimum difference（MMD） and average real variability（ARV） were examined; renal damage indexes as estimated glomerular filtration rate（eGFR） and microalbuminuria（ALBU） were detected. Relationships between different long-term, short-term SBPV indexes and eGFR, ALBU were studied by multi-liner regression analysis.Results：（1） The mean age of 2464 participants was（67.41 ± 6.05） years including 1667（67.7%） male and 797（32.3%） female.（2） Multi-liner regression analysis indicated that different long-term SBPV indexes were not related to eGFR and ALBU; 24 h SBPV in all 4 indexes and day-time SSD, MMD, ARV were negatively related to eGFR; 24 h ARV and day-time MMD, ARV were positively related to ALBU; night-time SBPV indexes were not related to eGFR and ALBU.Conclusion： Different short-term SBPV indexes were, at certain point related to eGFR and ALBU.