2740人基线血压水平及10年后血压变化与血清肌酐水平的关系  

A cohort study on blood pressure and serum creatinine

作　　者：李翠芬[1] 赵冬[1] 王薇[1] 刘军[1] 刘飒[1] 孙佳艺[1] 吴兆苏[1] 

机构地区：[1]首都医科大学附属北京安贞医院,北京市心肺血管疾病研究所流行病研究室,100029

出　　处：《中华肾脏病杂志》2006年第7期402-405,共4页Chinese Journal of Nephrology

基　　金："八五"国家科技攻关课题(85-915-01-02);北京心血管病高技术实验室资助项目(953850700)

摘　　要：目的探讨北京部分城区队列人群基线血压水平(1992年)及10年后(2002-2003年)血压的变化与血清肌酐(Scr)水平的关系。方法1992年对北京大学社区和首钢地区35- 64岁人群进行心血管疾病危险因素的调查,取得了基线数据。2002年对上述人群(45-74岁)进行复查,复查中加入了Scr检测指标。对两次资料完整的2740人基线血压水平及10年后血压变化与Scr水平的关系进行分析。结果(1)北京部分城区45-74岁人群平均Scr水平为(87．52±20.33)μmol／L,男性Scr[(96．36±15．92)μmol／L]高于女性[(80.44±21．22)μmol／L] (P<0．01)。(2)上述人群中Scr水平异常的发病率为8．7％,男性(13．6％)高于女性(4．4％)(P< 0．01)。其中,肾功能受损的发病率为0．9％,男性(1．6％)高于女性(0．3％)(P<0．01)。(3)随着基线血压水平的升高,10年后Scr水平呈增加趋势(P<0．01)。调整性别、年龄、体质指数、血糖、总胆固醇、高密度脂蛋白胆固醇和吸烟等变量后,基线血压≥180／110mm Hg组Scr水平异常的相对危险是血压<120／80 mm Hg组的3．89倍(95％CI:1．51-10．04)。(4)Scr水平异常的发病率在1992年和2002年血压均正常的人群为6．6％;在1992年为高血压到2002年血压控制到正常的人群为12．4％;在1992年和2002年均为高血压的人群为16．9％。结论高血压与Scr水平密切相关,有效控制血压能够延缓Scr水平的上升,在一定程度上保护肾功能。Objective To explore the association of baseline blood pressure level in 1992 and its change from 1992 to 2002 with serum creatinine （Scr） in a cohort of 2740 subjects in Beijing. Methods A baseline investigation on the risk factom of cardiovascular disease was carried out in a natural population of Beijing in 1992. The follow-up survey was conducted in 2002, adding Ser as a new index. Complete data were available for 2740 subjects. Elevation of Scr level was defined as Scr level from 115μ mol/L to 133 μmol/L in male and from 107μmol/L to 124μmol/L in female. Renal damage was defined as Scr〉133μmol/L in male and Scr〉124 μmol/L in female. These two stages were identified as abnormity of Scr in this study. Results （1） In 2002, the mean level of scr was （87.52±20.33）μmol/L in the samples of 45-74 years old. Male [（96.36± 15.92）μmol/L] had a significantly higher level than female [（80.44±21.22）μmol/L]. （2） In this population,the incidence of abnormal Scr was 8.7%. The incidence of male （13.6%） was significantly higher than that of female （4.4%）. （3）The incidence of abnormal Scr continually increased with elevation of baseline blood pressure level （P〈 0.01）. After adjusting for gender, age, BMI and other factors,the odds ratios（OR）of abnormal Scr was 3.89 for BP≥180/ll0 mm Hg, compared to the group of BP〈 120/80 mm Hg. （4） The incidence of abnormal Scr was 6.6% in subjects who had normal BP in both 1992 and 2002, whereas the incidence was 12.4% in the subjects who were hypertensive in 1992 but controlled in 2002 and 16.9% in those who were hypertensive both in 1992 and 2002. Conclusion Effective control on hypertension will be helpful to prevent or postpone the elevation of Scr.

关 键 词：高血压 肌酸酐 肾疾病 队列研究 

分 类 号：R692[医药卫生—泌尿科学]