舒张压异常对肾功能的影响

The relationship between diastolic blood pressure and the decline of renal function

目的探讨舒张压与估算的肾小球滤过率(eGFR)下降的关系。方法收集2010-2012年徐州市中心医院健康体检者64 066人,应用中国肾脏病膳食改良公式(C-MDRD)方程计算eGFR,将研究人群分为eGFR正常组[≥60mL/(min·1.73m2)]和eGFR下降组[<60mL/(min·1.73m2)]。通过Logistic回归分析高舒张压与肾功能下降的关系。结果与eGFR正常组比较,eGFR下降组年龄较大[(68.3±13.6)比(47.5±13.4)岁,P<0.05],舒张压[(86.7±14.1)比(80.2±11.7)mm Hg,P<0.05]、收缩压[(143.5±19.8)比(126.9±17.1)mm Hg,P<0.05]较高,空腹血糖[(5.94±1.69)比(5.38±1.25)mmol/L,P<0.05]、三酰甘油[(1.77±1.31)比(1.50±1.44)mmol/L,P<0.05]较高,高密度脂蛋白胆固醇(HDL-C)[(1.19±0.32)比(1.28±0.34)mmol/L,P<0.05]、体质量指数(BMI)[(34.8±12.4)比(37.6±12.5)kg/m2,P<0.05]较低。多因素Logistic回归分析显示,控制年龄、性别、收缩压、三酰甘油、HDL-C、BMI后,舒张压对肾功能下降的影响有统计学意义(OR=1.523,P<0.05)。结论舒张压与肾功能下降相关。

Objective To investigate the relationship between diastolic blood pressure（DBP）and estimated glomerular filtration rate（eGFR）. Methods A total of 64 066 healthy physical examinees in Xuzhou Central Hospital from 2010 to 2012 were enrolled and divided into 2 groups based on eGFR calculated by Chinese modification of diet in renal disease（C-MDRD）equation：eGFR normal group[〉60 mL/（min·1.73 m^2）]and eGFR decline group[60 mL/（min·1.73 m^2）]. Logistic regression analysis was used to investigate the relationship between DBP and eGFR.Results Compared with the normal eGFR group,in the eGFR decline group the examinees were older [（68.3±13.6）vs（47.5±13.4）years,P〈0.05];and the DBP [（86.7±14.1）vs（80.2±11.7）mm Hg,P〈0.05],systolic blood pressure[（143.5±19.8）vs（126.9±17.1）mm Hg,P〈0.05],fasting blood glucose[（5.94±1.69）vs（5.38±1.25）mmol/L,P〈0.05]and triglycerides [（1.77±1.31）vs（1.50±1.44）mmol/L,P〈0.05]were higher;while high density lipoprotein cholesterol（HDL-C）[（1.19±0.32）vs（1.28±0.34）mmol/L,P〈0.05]and body mass index（BMI）[（34.8±12.4）vs（37.6±12.5）kg/m^2,P〈0.05]were lower. Multivariable logistic regression analysis showed that after adjusting for age,gender,triglycerides,HDL-C,systolic blood pressure and BMI,DBP showed a significant effect on kidney function decline（OR=1.523,P〈0.05）. Conclusion DBP was significantly associated with renal function decline.