老年高血压患者动态动脉硬化指数与早期肾损害的关系  

Relationship between ambulatory arterial stiffness index and early renal damage in elderly patients with essential hypertension

作　　者：刘平[1] 陈蕾[2] 刘丽芳[1] 张力[1] 

机构地区：[1]空军总医院干部病房,北京100142 [2]空军总医院生理实验室,北京100142

出　　处：《中华保健医学杂志》2014年第5期361-363,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的了解动态动脉硬化指数(AASI)对老年高血压患者早期肾损害的预测价值。方法选取140例老年高血压患者,根据尿白蛋白/肌酐比(ACR)水平分为微量白蛋白尿组与尿白蛋白正常组,对两组间性别、年龄、体质量指数(BMI)、空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、估算的肾小球滤过率(e GFR)、AASI等进行比较。根据AASI水平分为AASI≥0.55组与AASI<0.55组,对两组间性别、年龄、BMI、FPG、TC、TG、e GFR、ACR水平及ACR阳性率等进行比较。采用多元逐步回归分析法对老年高血压患者ACR、e GFR与年龄、BMI、AASI等的关系进行分析。结果微量白蛋白尿组的年龄和AASI显著高于尿白蛋白正常组(P<0.01),而e GFR、24 h平均舒张压(24 h ADBP)显著低于尿白蛋白正常组(P<0.01)。AASI≥0.55组的年龄、ACR水平、ACR阳性率显著高于AASI<0.55组(P<0.01),而e GFR、24 h ADBP显著低于AASI<0.55组(P<0.01)。ACR与年龄(β=0.351,P=0.000)、AASI(β=0.450,P=0.000)呈显著正相关;而e GFR与年龄(β=-0.150,P=0.037)、AASI(β=-0.587,P=0.000)呈显著负相关。结论 AASI对老年高血压患者的早期肾功能损害可能具有预测价值。Objective To investigate the value of ambulatory arterial stiffness index（AASI） as a predictor of early renal dam-age in elderly patients with essential hypertension（EH）. Methods According to urinary albumin/creatinine ratio（ACR）,140 cases of elderly hypertensive patients were divided into microalbuminuric patients group and nomoalbuminuric patients group. The differences in gender,age,body mass index（BMI）,fasting glucose,total cholesterol,triglycerides,estimated glomerular filtration rate（e GFR）,and AASI between the two groups were analyzed. Next,the same sample group was divided into AASI ≥ 0.55 group and AASI 0.55 group,and the differences in gender,age,BMI,fasting glucose,total cholesterol, triglycerides,e GFR,and ACR between the two groups were investigated. In addition,the association of ACR and e GFR with age,BMI,and AASI were studied in the case of elderly hypertensive patients. Results Microalbuminuric group showed significantly higher age,and AASI（P〈0.01）,but significantly lower e GFR,24 h ADBP（P〈0.01） than nomoalbuminuric group. AASI≥0.55 group showed significantly higher age,e GFR,and ACR（P〈0.01）,but significantly lower 24 h ADBP（P〈0.01） than AASI 0.55 group. In elderly hypertensive patients,ACR was positively correlated with age（β = 0.351,P = 0.000） and AASI（β = 0.450,P = 0.000）,but e GFR was inversely correlated with age（β =- 0.150,P = 0.037） and AASI（β =- 0.587,P = 0.000）. Conclusion Our study suggests that AASI,derived from 24 h ambulatory pressure monitoring,can predict early renal damage in elderly hypertensive patients.

关 键 词：高血压 动态动脉硬化指数 尿白蛋白/肌酐比 估算的肾小球滤过率 老年 

分 类 号：R544.1[医药卫生—心血管疾病]