高龄原发性高血压患者合并慢性肾脏病的危险因素

Risk factors for essential hypertension complicated with chronic kidney disease in ≥80 years old patients

目的了解80岁以上原发性高血压(EH)住院患者合并慢性肾脏病(CKD)的情况,分析相关危险因素。方法选取南京医科大学第二附属医院心血管内科住院的1 555例65岁以上EH患者,依据是否≥80岁分为2组:高龄组(n=575)和非高龄组(n=980)。收集患者的临床资料。采用SPSS 22.0软件进行数据处理,logistic回归分析EH合并CKD的危险因素。结果与非高龄EH组患者比较,高龄EH组患者CKD发生率显著升高(52.9%vs 29.5%,P<0.05)。高龄EH患者合并CKD的危险因素依次为高尿酸血症(OR=2.514,95%CI 1.750～3.611; P <0.001)、年龄(OR=1.072,95%CI1.018～1.129;P=0.009)和收缩压(OR=1.019,95%CI 1.011～1.028; P <0.001),保护因素为高密度脂蛋白胆固醇(OR=0.516,95%CI 0.315～0.847;P=0.009);非高龄老年EH患者合并CKD的危险因素依次为高尿酸血症(OR=2.729,95%CI 1.991～3.740;P<0.001)、糖尿病(OR=1.944,95%CI 1.420～2.662;P<0.001)、年龄(OR=1.140,95%CI 1.101～1.182;P<0.001)和收缩压(OR=1.009,95%CI 1.003～1.016; P=0.007),保护因素为高密度脂蛋白胆固醇(OR=0.448,95%CI0.278～0.722;P=0.001)。结论高龄老年EH患者合并CKD的比例显著高于非高龄老年EH患者,高龄EH患者合并CKD与高尿酸血症、年龄、收缩压及高密度脂蛋白胆固醇水平有关。

Objective To analyze the risk factors for chronic kidney disease(CKD)complication in essential hypertension(EH)patients≥80 years of age.Methods A total of 1 555 elderly EH patients aged over 65 years old admitted to our department during March 2014 and June 2017 were enrolled in this study.They were assigned into≥80-year-old group(n=575)and<80-year-old group(n=980).Their clinical data were collected and analyzed.SPSS statistics 22.0 was used to analyze the data,and logistic regression analysis was employed to identify the risk factors for CKD.Results Compared with<80-year-old group,≥80-year-old group had significantly higher incidence of CKD(52.9%vs 29.5%,P<0.05).In≥80-year-old EH patients,the risk factors for CKD were hyperuricemia(OR=2.514,95%CI 1.750-3.611;P<0.001),age(OR=1.072,95%CI 1.018-1.129;P=0.009)and systolic blood pressure(OR=1.019,95%CI 1.011-1.028;P<0.001),and the protective factor was high-density lipoprotein cholesterol(OR=0.516,95%CI 0.315-0.847;P=0.009).While,for<80-year-old EH patients,the risk factors were hyperuricemia(OR=2.729,95%CI 1.991-3.740;P<0.001),diabetes mellitus(OR=1.944,95%CI 1.420-2.662;P<0.001),age(OR=1.140,95%CI 1.101-1.182;P=0.009)and systolic blood pressure(OR=1.009,95%CI 1.003-1.016;P=0.007),and the protective factor was high-density lipoprotein cholesterol(OR=0.448,95%CI 0.278-0.722;P=0.001).Conclusion The incidence rate of CKD in≥80-year-old EH patients is obviously higher than that in<80-year-old EH patients.The complication of CKD is associated with age,hyperuricemia,systolic blood pressure and high-density lipoprotein cholesterol in≥80-year-old EH patients.