高血压患者肾脏损害影响因素分析

An analysis of factors influencing kidney damage in patients with hypertension

目的分析单纯高血压患者肾脏损害的影响因素。方法收集健康体检人群资料,分析健康人群(A组,1309例)和单纯高血压患者(B组,660例)估算的肾小球滤过率(eGFR)水平差异。B组患者进一步分为eGFR<90 mL·min^-1·1.73 m^-2组(B1组,411例)和eGFR≥90 mL·min^-1·1.73·m^-2组(B2组,249例),比较两组血压、血脂、血糖和尿酸等的差异。采用多重线性回归分析单纯高血压患者eGFR的影响因素。结果A组eGFR水平高于B组(P<0.01)。A、B组中的女性患者eGFR水平均高于男性患者(P<0.01)。B1与B2组体重、SBP、脉压差(PP)、FBG、TG、血尿素氮(BUN)、血尿酸(SUA)和TBil比较差异均有统计学意义(P<0.05)。多重线性回归分析结果显示,eGFR与LDL-C、ALT、AST、BUN、SUA、FBG、TC、SBP、WBC、RBC、Plt和PP的线性回归关系有统计学意义(P<0.05)。eGFR水平随LDL-C、AST、BUN、SUA、FBG、SBP、WBC和PP的升高而降低,随ALT、TC、RBC和Plt的升高而升高。结论高血压肾脏损害与性别、肥胖、血压、血脂和尿酸等因素相关;应充分重视高血压肾脏损害的危险因素,早期干预,以延缓和治疗高血压肾脏损害。

Objective To analyze the factors influencing kidney damage in patients with simple hypertension.Methods The data of health physical examination people were collected and the difference of estimated glomerular filtration rate(eGFR)was compared between the patients with simple hypertension(group B,660 cases)and healthy people(group A,1309 cases).The patients in group B were further divided into two groups of B1(eGFR<90 mL·min^-1·1.73·m^-2,411 cases)and B2(eGFR≥90 mL·min^-1·1.73 m^-2,249 cases).Blood pressure,blood lipids,fasting blood glucose(FBG),blood uric acid(UA)were compared between groups of B1 and B2.Multiple linear regression was used to analyze the factors influencing eGFR in the patients with simple hypertension.Results The eGFR level in group B was lower than that in group A(P<0.01),which in group B was higher in the females than that in the males(P<0.01).There were significant differences in body weight,SBP,pulse pressure difference(PP),FBG,TG,blood urea nitrogen(BUN),UA and TBil between groups of B1 and B2(P<0.05).Multiple linear regression analysis showed that eGFR level was closely related to the LDL-C,ALT,AST,BUN,UA,FBG,TC,SBP,WBC,RBC,Plt,and PP(P<0.05).The eGFR level was decreased as the increases of LDL-C,AST,BUN,UA,FBG,SBP,WBC and PP.The eGFR level was increased as the increases of ALT,TC,RBC and Plt.ConclusionHypertensive kidney damage is related to gender,obesity,BP,blood lipids,UA and other factors.Attention should be paied to the risk factors for hypertensive kidney damage and early intervention needs to be taken to treat and attenuate hypertensive kidney damage.