血清总胆红素对原发性高血压患者早期肾功能损害的预测价值  

Value of serum total bilirubin level in predicting early-stage renal function damage in patients with essential hypertension

作　　者：刘建峰 武艺[2] 华琦[3] LIU Jian-feng;WU Yi;HUA Qi(Xicheng District Boai Hospital,Beijing 100055,China)

机构地区：[1]北京市西城区平安医院,100055 [2]首都医科大学康复医学院北京博爱医院心内科,100068 [3]首都医科大学宣武医院心脏科,100053

出　　处：《中国实用医药》2021年第13期21-24,共4页China Practical Medicine

摘　　要：目的探讨血清总胆红素(TBIL)水平对原发性高血压患者早期肾功能损害的预测价值。方法 300例新发未经治疗的原发性高血压患者,收集患者性别、年龄、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、空腹血糖(FBG)、血清肌酐(SCr)、尿酸(UA)、TBIL。根据估算的肾小球滤过率(eGFR)水平将患者分为肾功能受损组(81例)、肾功能正常组(219例)。采用Logistic回归分析原发性高血压患者早期肾功能损害的影响因素。采用Pearson分析各变量与eGFR的相关性。结果肾功能正常组患者的年龄(58.06±6.89)岁、BMI(25.23±2.45)kg/m~2、SBP(153.06±11.43)mm Hg(1 mm Hg=0.133 kPa)、TBIL(14.74±4.67)μmol/L、SCr(58.27±11.22)mmol/L、UA(305.94±74.82)mmol/L、eGFR(118.31±24.57)ml/(min·1.73m2)与肾功能受损组患者的(61.46±7.44)岁、(27.93±3.04)kg/m~2、(165.81±14.18)mm Hg、(11.16±3.75)μmol/L、(87.74±20.71)mmol/L、(368.51±97.75)mmol/L、(73.47±11.97)ml/(min·1.73m~2)比较,差异均具有统计学意义(P<0.05)。Pearson相关性分析显示,年龄、SBP、BMI与e GFR呈负相关(r=-0.199、-0.189、-0.267, P<0.05), TBIL与e GFR呈正相关(r=0.517, P<0.05)。Logistic回归分析显示, BMI、SBP、UA均为原发性高血压患者早期肾功能损害的影响因素,且TBIL是高血压患者早期肾功能损害的保护因素(P<0.05)。结论原发性高血压患者TBIL水平的变化可能反映了肾功能的变化;TBIL降低是原发性高血压患者早期肾功能损害的独立危险因素。Objective To discuss the value of serum total bilirubin level in predicting early-stage renal function damage in patients with essential hypertension.Methods There were 300 newly untreated patients with essential hypertension as study subjects.The gender,age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),Low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglycerides(TG),fasting blood glucose(FBG),serum creatinine(SCr),uric acid(UA),TBIL were collected.According to the estimated glomerular filtration rate(eGFR)level,the patients were divided into renal dysfunction group(81 cases)and normal renal function group(219 cases).Logistic regression was used to analyze the influencing factors of early-stage renal function damage in patients with essential hypertension,and Pearson was used to analyze the correlation between each variable and eGFR.Results The age,BMI,SBP,TBIL,SCr,UA and eGFR of normal renal function group were(58.06±6.89)years of age,(25.23±2.45)kg/m2,(153.06±11.43)mm Hg(1 mm Hg=0.133 kPa),(14.74±4.67)μmol/L,(58.27±11.22)mmol/L,(305.94±74.82)mmol/L and(118.31±24.57)ml/(min·1.73m2),which had statistically significant difference compared with(61.46±7.44)years of age,(27.93±3.04)kg/m2,(165.81±14.18)mm Hg,(11.16±3.75)μmol/L,(87.74±20.71)mmol/L,(368.51±97.75)mmol/L and(73.47±11.97)ml/(min·1.73 m2)of renal dysfunction group(P<0.05).Pearson correlation analysis showed that age,SBP,BMI were negatively correlated with eGFR(r=-0.199,-0.189,-0.267;P<0.05),and TBIL was positively correlated with EGFR(r=0.517,P<0.05).Logistic regression analysis showed that BMI,SBP and UA were the influencing factors of early-stage renal function damage in patients with essential hypertension,and TBIL was the protective factor of early-stage renal function damage in patients with essential hypertension(P<0.05).Conclusion Changes in TBIL levels in patients with essenti

关 键 词：原发性高血压 血清总胆红素 肾脏损害 肾小球滤过率 

分 类 号：R544.11[医药卫生—心血管疾病] R692[医药卫生—内科学]