盐摄入量与老年高血压患者早期肾损害相关性研究

Study on the relationship between salt intake with early renal damage in elderly patients with hypertension

目的针对不同盐摄入量对老年高血压患者早期肾损害程度及其相关性进行讨论,为进一步制定个性化限盐计划及老年高血压的防治工作提供依据。方法抽取2018年1月-2019年12月在云南省阜外心血管病医院门诊就诊的老年高血压患者122例,均行24 h尿电解质检查,符合本研究条件,临床资料完善。依据24 h尿钠的排泄量将研究对象分为低盐组、中等盐组和高盐组,分别采集患者一般情况信息,记录动脉硬化检测结果及尿微量白蛋白等实验结果。以微量白蛋白尿作为判定肾脏早期损害的指标,观察不同盐摄入量与肾脏早期损害相关关系。结果不同盐摄入组24h平均尿钠值分别为(66.89±24.63)、(141.84±25.19)、(244.32±46.5)mmol/24h,分别对应的平均盐摄入量为(4.35±1.60)、(9.22±1.64)、(15.89±3.02)g/d,3组间24 h尿钠差异有统计学意义(F=232.44,P<0.01)。高盐组尿微量白蛋白水平明显高于低盐组和中等盐组(P<0.001);多因素Logistics回归显示:baPWV、24 h尿钠是微量白蛋白尿的危险因素(P<0.05)。结论盐摄入量与老年高血压患者肾脏早期损害相关,其影响独立于血压之外。

Objective To explore the degree of different salt intake on early renal damage in elderly patients with hypertension and its correlation,so as to provide basis for further formulating personalized salt-limiting plans and prevention and treatment of elderly hypertension. Methods From January 2018 to December 2019,122 elderly patients with hypertensive in the outpatient department of Fuwai Cardiovascular Hospital of Yunnan Province were selected. All of them underwent 24h urine electrolyte examination,which met the conditions of this study and had perfect clinical data. The subjects were divided into low-salt group,medium-salt group and high-salt group according to the 24h urinary sodium excretion. The general information of the patients was collected,and the results of arteriosclerosis test and urinary microalbumin test were recorded. Microalbuminuria was used as an index to determine early renal damage,and the correlation between different salt intake and early renal damage was observed. Results The mean 24-hour average urinary sodium values of different salt intake groups were( 66. 89 ± 24. 63),( 141. 84 ± 25. 19),( 244. 32 ± 46. 5) mmol/24h,and the corresponding average salt intakes were( 4. 35 ± 1. 60),( 9. 22 ± 1. 64),and( 15. 89 ± 3. 02) g/d. There were statistical significance in the difference of 24h urine sodium among the three groups( F = 232. 44,P < 0. 01). Urine microalbumin level [4. 6( 1. 3 ~ 9. 91) mg/dl] in high-salt group was significantly higher than that in low-salt group and medium-salt group. Multivariate Logistic regression showed that ba PWV and 24h urine sodium were the risk factors for microalbuminuria( P < 0. 05). Conclusions Salt intake is related to early renal damage in elderly hypertensive patients,and its effect is independent of blood pressure.