高龄老年H型高血压患者动脉粥样硬化与肾功能的关系

Carotid atherosclerosis and renal function in elderly H-type hypertensive patients

目的:探讨高龄H型高血压患者血清同型半胱氨酸(Hcy)、颈动脉内膜中层厚度(c IMT)与肌酐(Cr)、尿酸(UA)、尿素氮(BUN)、胱抑素C(Cys-C)等肾功能指标的关系。方法:将120例高血压患者按Hcy水平分为A、B、C三组,比较各指标的差异并计算相关性。按c IMT增厚与否分为两组,比较各危险因素并进行Logistic回归分析。结果:c IMT、Cys-C、Cr、BUN、UA的水平在A、B、C三组逐渐升高,在A、C组间差异有统计学意义;Hcy、c IMT在任意两组间的差异均有统计学意义。多元相关分析发现,Hcy与c IMT、肾功能各指标有相关性;c IMT仅和尿酸、Hcy存在相关性。Logistic回归分析发现仅Hcy是c IMT增厚的独立危险因素。结论:高龄H型高血压患者的动脉粥样硬化进展和肾功能不全有相关性。

Objective：To explore the relationship among plasma homocysteine（Hcy）level,indicators of renal function（including creatine,Cr;uric acid,UA;urea nitrogen,BUN;cystatin-C,Cys-C） and carotid intima-media thickness（cIMT） in the elderly hypertensive patients with hyperhomocystinemia.Methods：120 hypertensive patients were allocated to three groups （group A,group B,group C） based on the Hcy levels measured,and indicators were calculated and compared among patients.Then the patients were subgrouped into two by cIMT for compassion of the risk factors through Logistic regression analysis.Results：Gradually elevated levels of cIMT,Cys-C,Cr,BUN and UA were observed in group A,B and C.Those levels were significantly different between group A and group C,and the difference was significant in either of the two groups regarding Hcy and cIMT.Logistic regression analysis indicated that Hcy was exclusively independent risk factor for cIMT.Conclusion： Progression of atherosclerosis appears associated with renal dysfunction in elderly patients with H-type hypertension.