北京市3006例原发性高血压中老年患者eGFR的分布情况及影响因素

Distribution of eGFR and its Influencing Factors in 3006 Patients with Essential Hypertension in Beijing

目的:开展北京市东城区原发性高血压中老年患者肾功能情况的调查,探讨高血压eGFR水平的分布及影响因素。方法:按纳入标准选择原发性高血压患者3006例,收集一般资料、生化指标、中医证候特点等信息,采用CKD-EPI公式计算eGFR,并用SPSS 25.0统计软件对数据进行处理。结果:(1)高血压患者eGFR水平分布:eGFR≥90组、60≤eGFR<90组、eGFR<60组的比例分别为:47.6%、43.4%、9.0%,其中60≤eGFR<90和eGFR<60两组中的年龄、高血压病程、舒张压、胆固醇、尿酸、肌酐、HCY较eGFR≥90组均显著增高,而HDL较eGFR≥90均显著降低,差异有统计学意义(P<0.05)。(2)中医证候上,总体证型分布:阴虚阳亢证>肝火上炎证>气血亏虚证>痰湿壅盛证>瘀血阻络证>阴阳两虚证>肾精不足证,而eGFR<60组的阴虚阳亢证、痰湿壅盛证的比例相较其他两组明显升高,而气血亏虚证、瘀血阻络证的比例有所下降。(3)logistic回归分析显示,男性、有饮酒史、舒张压、三酰甘油、血糖、尿酸水平较高及气血亏虚证的患者更容易出现肾功能的下降。结论:肾功能的轻中度下降在高血压患者中并不少见,且这部分患者在理化指标、证候表现与其他患者具有一定的差异。除性别、年龄等不可干预因素及饮酒等个人生活习惯外,在临床中应积极防治血压、血糖、血脂及尿酸等可干预因素,对高血压合并肾损伤早期进行有效预防和治疗。

Objective:To investigate the renal function of patients with essential hypertension in dongcheng district, Bei-jing, and to explore the distribution and influencing factors of hypertension eGFR level.Methods:3006 patients with essential hyper-tension were selected according to the inclusion criteria, and general data, biochemical indicators, TCM syndrome characteristics andother information were collected. EGFR was calculated by ckd-epi formula, and the data were processed by SPSS 25. 0 statisticalsoftware, so as to analyze the influencing factors of eGFR decline.Results:(1)EGFR level distribution in blood pressure patients:EGFR 90 or more groups、60≤eGFR < 90 groups of、EGFR < 60 group the proportions were: 47. 6 percent, 43. 4 percent and 9. 0 per-cent, respectively. The 60≤eGFR < 90 and eGFR < 60 Age, duration of hypertension, diastolic blood pressure, cholesterol, uricacid, creatinine, and HCY in the two groups were significantly higher than eGFR≥90, while HDL was significantly lower than eGFR≥90, and the differences were statistically significant(P< 0. 05).(2) On TCM syndrome, the overall distribution of syndrometypes: Yin deficiency and Yang hyperactivity syndrome >Inflammation on irascibility > Deficiency syndrome of qi and blood> Excessive phlegm-dampness syndrome >Stasis syndrome > Deficiency syndrome of Yin and Yang >Kidney essencedeficiency, while egfr;Compared with the other two groups, the proportion of Yin deficiency Yang excess syndrome and phlegm-dampness accumulated syndrome in group 60 was significantly increased, while the proportion of qi and blood deficiency syndrome andblood stasis blocking collaterals decreased.(3) Logistic regression analysis showed that men, patients with a history of alcohol con-sumption, high diastolic blood pressure, triglycerides, blood glucose, uric acid levels and qi and blood deficiency syndrome weremore likely to have decreased renal function.Conclusion:Mild to moderate decrease of renal function is not uncommon in patientswith hypertension, and the physical and chemical indexes and syndrome of these patients are different from those of other patients. Inaddition to gender, age and other non-interventional factors, as well as personal lifestyle factors such as alcohol consumption, the in-terventional factors such as blood pressure, blood glucose, blood lipid and uric acid should be actively prevented and treated in theclinic, so as to effectively prevent and treat hypertension with renal injury in the early stage.