原发性高血压病患者主动脉根部指数与肾小球滤过率的关系

Relationship between Aortic Root Diameter and Glomerular Filtration Rate in Essential Hypertensive Patients

目的探讨原发性高血压病患者主动脉根部指数(ARD/H)与估测肾小球滤过率(eGFR)的关系及其影响因素。方法回顾性分析296例原发性高血压病患者的临床资料,采用二维超声心动图测量主动脉根部宽度(ARD)、主动脉根部宽度/身高(ARD/H);经CKD-EPI法检测eGFR;脉搏波传导速度(baPWV)评价动脉弹性功能;采用中心动脉收缩压(CSBP)、外周收缩压(PSBP)、外周舒张压(PDBP)、脉压差(PP)评价血流动力学变化;根据eGFR将入选者分为4组(n=74):eGFR 1组[eGFR>103.57 mL/(min·1.73 m^2)],eGFR 2组[eGFR 92.91~103.57 mL/(min·1.73 m^2)],eGFR 3组[eGFR 80.91~92.90 mL/(min·1.73 m^2)],eGFR 4组[eGFR<80.91 mL/(min·1.73 m^2)]。结果(1)ARD/H随着eGFR降低而增宽。经多因素校正,ARD/H组间差别均有统计学意义[ARD/H分别为:(2.04±0.20),(2.10±0.19),(2.13±0.19),(2.13±0.20),P<0.05]。(2)ARD/H与年龄、eGFR、LVMI相关(相关系数r分别为0.212,-0.188,0.156,P<0.05)。(3)经多元线性逐步回归分析,ARD/H与eGFR仍呈负相关,eGFR每下降10 mL/(min·1.73 m^2),ARD/H增宽0.03 cm/m。结论ARD/H与eGFR、LVMI密切相关,可能与心血管重塑有关。

Objective To investigate the relationship between aortic root diameter was indexed to height(ARD/H)and estimates glomerular filtration rate(eGFR)in essential hypertensive patients.Methods The 296 essential hypertensive patients were enrolled.ARD at the level of Valsava's sinuses was measured by a two-dimensional echocardiography,ARD was indexed to height(ARD/H).eGFR was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation(CKD-EPI).Brachial-ankle Pulse wave velocity(ba-PWV)was used to evaluate the arterial elasticity.The participants was equally categorized into four groups:eGFR 1[n=74,eGFR>103.57 mL/(min·1.73 m^2)],eGFR 2[n=74,eGFR 92.91-103.57 mL/(min·1.73 m^2)],eGFR 3[n=74,eGFR 80.91-92.90 mL/(min·1.73 m^2)],eGFR 4[n=74,eGFR<80.91 mL/(min·1.73 m^2)].Results(1)ARD/H showed a stepwise increase from the groups with Chronic Kidney Disease(CKD),after adjustment for various confounding factors,ARD/H showed significantly different in groups(ARD/H:(2.04±0.20),(2.10±0.19),(2.13±0.19),(2.13±0.20),P<0.05).(2)Age,eGFR and LVMI correlated significantly with ARD/H(r=0.212,-0.188,0.156,P<0.05).(3)After adjustment for various confounding factors,eGFR decreases 10 mL/(min·1.73 m^2)with 0.03 cm/m increased in ARD/H.Conclusion The study seems to suggest that aortic root diameter was indexed to height(ARD/H)is correlation with glomerular filtration rate and left ventricular mass index in essential hypertensive patients,which may be correlation with cardiovascular remodeling.