高龄高血压患者静息心率与肾脏损害的相关性  

Resting heart rate and impaired renal function in very old hypertensive patients

作　　者：王文艳[1] 张维[1] 谢蒂立[1] 钟萍[1] 周晓芳[1] 刘新[1] 

机构地区：[1]四川省医学科学院：四川省人民医院,老年疾病研究所,成都610072

出　　处：《中华老年多器官疾病杂志》2012年第1期18-21,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的 探讨高龄高血压患者静息心率（ RHR）与肾脏功能指标的相关性.方法 2006年9月～2011年2月入住本院患者419例为研究对象,男289例,女130例,年龄80～94岁,平均（80.8±6.1）岁.按照RHR分为A组：RHR＜ 70 beats/min,B组：RHR 70～80次/min,C组：RHR＞ 80次/min,同时进行血压、体质量指数（BMI）、糖化血红蛋白、吸烟指数（SI）的检测,用肾小球滤过率（ GFR）、血肌酐（SCr）、肌酐清除率（CCr）,微量白蛋白尿（MAU）评估肾功能,分析静息心率与肾功能参数的相关性.结果 三组平均RHR差异有统计学意义[A,B,C组分别为（63.4±7.2）,（74.1±4.0）,（84.3±8.8）次/min,P＜0.05]；三组SI和收缩压（SBP）均存在差异[A,B,C组SI分别为（321±73）,（ 378±99）,（463±79）（支·年）； SBP分别为（140.2±10.1）,（146.3±8.1）,（149.8±9.6） mmHg,P＜0.05].C组BMI和舒张压（DBP）均明显高于另外两组[A,B,C组BMI分别为（23.7±3.0）,（23.1±5.4）,（25.9±5.9） kg/m2;DBP分别为（64.6±9.5）,（65.2±9.1）,（71.3±12.4） mmHg,P＜0.05]；三组肾功能参数差异有统计学意义[A,B,C组GFR分别为（84.5±11.0）,（78.2±10.6）,（67.6±10.1） ml/min; SCr分别为（87.3±23.1）,（90.0±22.3）,（ 104.0±19.7） μmol/L,CCr分别为（73.9±16.8）,（68.0±18.3）,（62.5±20.1） ml/min,MAU分别为（51.4±11.3）,（ 56.0±17.3）,（90.9±22.8） mg/L,P＜0.05].RHR分别与SBP（ r=0.264,P=0.002）,GFR（r=-0.330,P=0.011）,CCr（r=-0.436,P＜0.01）和MAU（r=0.208,P=0.029）存在相关性.结论 高龄高血压患者RHR与肾功能损害相关,提示RHR增快可以作为高龄高血压患者肾功能受损的预测因子.Objective Resting heart rate（RHR） symbolizes the sympathetic nerve activity and is correlated with target organ damage in hypertensive subjects. This study aimed to investigate the relation between RHR and the parameters of renal function and other risk factors in elderly hypertensive patients. Methods Totally 419 in-hospital patients from September, 2006 to February, 2011 were enrolled, including 289 males and 130 females, with age ranging from 80±94 years, averaged （80.8 ± 6.1） years. The subjects were divided into three groups according to RHR： group A, RHR 〈 70 beats/min; group B, RHR 70±80 beats/rain; group C, RHR 〉 80 beats/min. The blood pressure, body mass index（BMI）, smoking index（SI） and glycosylated hemoglobin A（HbAc0 were determined. Renal function were evaluated by glomerular filtration rate（GFR） which was determined by Single Photon Emission Computed Tomography（SPECT）, serum creatinine （SCr）, creatinine clearance（CCr） and micro albumin uria （MAU） respectively. The relation between RHR and these parameters was identified by simple correlation analysis. Results The RHR was significantly different between the three groups [（63.4 ± 7.2）, （74.1 ± 4.0）, and （84.3 ± 8.8） beats/min in group A, B and C respectively, P 〈 0.05], as well as SI [（321 ± 73）, （378 ± 99）, and （463 ± 79） （cigarettes ± year）in group A, B and C respectively, P 〈 0.05] and SBP [（140.2 ± 10.1）, （146.3 ± 8.1） and （149.8 ± 9.6）mmHg in group A, B and C respectively, P 〈 0.05]. No significant difference was found in age, hypertension course, diabetes and HbAcl level among the three groups. BMI and DBP were higher in group C than in group A and B[BMI：（23.7 ± 3.0）, （23.1 ± 5.4）, （25.9 ± 5.9）kg/m2; DBP： （64.6 ± 9.5）, （65.2 ± 9.1）, （71.3 ± 12.4）mmHg in group A, B, C respectively, P 〈 0.05]. Significant difference in GFR[（84.5 ± 11.0）, （78.2 ± 10.6） and （67.6 ± 10.1）ml/min in group A, B and C r

关 键 词：静息心率 高血压 肾功能 微量蛋白尿 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]