累积收缩压与估算的肾小球滤过率的关系  

The correlation between cumulative systolic blood pressure and estimated glomerular filtration rate

作　　者：宋绍敏[1] 宋路[2,3] 李春慧[2,3] 赵华灵[2,3] 王一鸣[2,3] 李春盛[4] 陈志超[4] 曾春艳 陈朔华[3] 吴寿岭[3] 

机构地区：[1]开滦总医院林西医院心内科,河北唐山063000 [2]华北理工大学研究生院 [3]开滦总医院心内科 [4]汕头大学医学院

出　　处：《中华高血压杂志》2016年第2期135-140,共6页Chinese Journal of Hypertension

摘　　要：目的探讨累积收缩压（cumSBP）与估算的肾小球滤过率（eGFR）的关系。方法在参加开滦集团2006-2007年度健康体检的职工101 510人中按抽样标准分层随机抽取观察对象,共抽取5852人,符合入选标准的为5440人,并于2012-2013年对该人群进行了第4次健康体检,并检测其肌酐水平,最终有4900名观察对象纳入统计分析。cumSBP=[（收缩压06＋收缩压08）/2×time06-08]＋[（收缩压08＋收缩压10）/2×time08-10]＋[（收缩压10＋收缩压12）/2×time10-12],其中收缩压06、收缩压08、收缩压10、收缩压12分别为第1次、第2次、第3次、第4次体检所测血压,time06-08、time08-10、time10-12为相邻两次收缩压测量的时间间隔。采用多因素Logistic回归方法,分析cumSBP与eGFR的关系。结果年龄（54.6±11.4）岁的观察对象4900人中,男性2897人（59.1%）,女性2003人（40.9%）。cumSBP六分位组eGFR水平差异有统计学意义（P〈0.05）,eGFR≤90mL/（min·1.73m2）的检出率随着cumSBP的增加而增加（P趋势〈0.05）。在多因素Logistic回归分析中,校正其他混杂因素后,结果显示与cumSBP第1六分位组相比,第2、第3、第4、第5、第6六分位组发生eGFR≤90mL/（min·1.73m2）的风险增加,OR值（95%CI）分别为1.69（1.15~2.48）、1.85（1.28~2.67）、2.62（1.82~3.77）、3.12（2.15~4.52）、3.61（2.50~5.21）。结论 cumSBP增加是eGFR降低的危险因素。Objective To investigate the correlation between cumulative systolic blood pressure（cumSBP）and estimated glomerular filtration rate（eGFR）. Methods A total of 5852 subjects were selected by standard stratified random sampling from all 101 510 employees of Tangshan Kailuan Group who received annual health examination during 2006 to 2007,in which 5440 participants met the inclusion criteria. Then those subjects received the 4th annual health examination during 2012 to 2013. After the evaluation of serum creatinine,there were 4900 participants finally enrolled. The cumSBP was determined as [（SBP06 ＋SBP08）/2×time06-08]＋ [（SBP08 ＋SBP10）/2×time08-10]＋[（SBP10＋SBP12）/2×time10-12]（SBP06,SBP08,SBP10 and SBP12was the systolic blood pressure taken at each annual health examination,and time06-08,time08-10,time10-12 was the time interval between two measurements of blood pressure. Multivariate Logistic regression was used to analyze the correlation between cumSBP and eGFR. Results The average age of the 4900 participants,including 2897（59.1%）males and 2003（40.9%）females,was（54.6±11.4）years. The difference of eGFR among cumSBP sextiles groups was statistically significant（P〈0.05）. The incidence of eGFR≤90 mL/（min·1.73 m2）rose with the increased cumSBP levels（Ptrend〈0.05）. Multivariate Logistic regression analysis showed that the incidence of eGFR≤90mL/（min·1.73m2）in the second,third,fourth,fifth,sixth cumSBP sextiles groups was higher than that in the first sextiles group,with OR（95% CI）1.69（1.15-2.48）,1.85（1.28-2.67）,2.62（1.82-3.77）,3.12（2.15-4.52）,3.61（2.50-5.21）respectively after adjusted for other confounding factors. Conclusion Increase of cumSBP is a risk factor for eGFR reduction.

关 键 词：累积收缩压 估算的肾小球滤过率 肾损害 

分 类 号：R544.1[医药卫生—心血管疾病]