健康老年人肾功能增龄性下降与早期动脉硬化的相关性研究  

The relationship between renal function delined with aging and arteriosclerosis in healthy elderly people

作　　者：徐兰[1] 赵雪兰[1] 赵霞娟[1] 张晓明[1] XU Lan;ZHAXuelan;ZHAO Xiajuan;ZHANG Xicoming(Huashan hospital fifited to Fudan uniersity,department of geriatrics,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院老年病科,200040

出　　处：《中国老年保健医学》2023年第2期29-33,共5页Chinese Journal of Geriatric Care

基　　金：上海市卫生健康委员会面上项目(编号:202140038)。

摘　　要：目的探讨健康老年人伴随增龄的肾功能下降与早期动脉硬化的关系。方法选取年龄60岁及以上在华山医院参加体检的健康老年人2823例,采用CKD-EPI公式估算肾小球滤过率(eGFR),检测颈股脉搏波传导速度(cfPWV)和颈动脉内中膜厚度(cIMT)、血糖、血脂、血尿酸等指标,分别根据eGFR四分位值和cfPWV值进行分组比较。结果eGFR和年龄、收缩压(SBP)、甘油三酯(TG)、低密度脂蛋白(LDL)、尿素氮(BUN)、血尿酸(SUA)的组间比较差异明显,随着年龄增加,eGFR出现增龄性的下降。随着eGFR水平的下降,cfPWV明显升高,cIMT增厚比例增加不明显。与cfPWV正常组比较,cfPWV增高组在年龄、SBP、DBP、CHO、LDL、BUN、SUA水平明显升高,eGFR水平明显降低,cIMT增厚的比例增加不显著。单因素分析提示cfPWV与年龄、SBP、DBP、CHO、BUN、SUA呈明显正相关,与eGFR呈明显负相关。Logistic回归分析显示,eGFR(OR=1.122,P<0.001)是cfPWV增高的独立危险因素,其他影响因素包括年龄(OR=1.081,P<0.001)、SBP(0R=1.281,P<0.001)、DBP(0R=0.781,P=0.036)、SUA(0R=1.178,P<0.001)。结论健康老年人伴随着eGFR增龄性下降,动脉弹性衰退可能先于颈动脉内膜的增厚。血压、血尿酸的严格控制可以更好防治健康人群动脉弹性的衰退。Objective To investigate the relationship between renal function declined with aging and arteriosclerosis in healthy people.Methods A total of 2823 healthy people who underwent physical examination in Huashan hospital with the age≥60 years old were selected.The CKD-EPI formula was used to estimate the eGFR,and the cervical-femoral pulse wave velocity(cfPWV),carotid intima-media thickness(cIMT),blood glucose,blood lipid,serum uric acid was measured.Participants were divided into groups according to the quartile of eCFR or cfPWV value.Results There were significant differences in eCFR,Age,SBP,TG,LDL,BUN,SUA among the groups with different eGFR.CfPWV increased significantly by declined eCFR,while cIMT did not change significantly.Compared with the normal cfPWV group,the levels of Age,SBP,DBP,CHO,LDL,BUN,SUA were significantly increased,and the level of eGFR was significantly decreased in the increased cfPWV group.The proportion of cIMT was not significantly different between two groups.Univariate analysis showed that cfPWV was positively correlated with Age,SBP,DBP,FBG,CHO,BUN,SUA,and negatively correlated with eCFR.Logistic regression analysis showed that Age(OR=1.081,P<0.001),SBP(OR=1.281,P<0.001),DBP(OR=0.781,P=0.036),SUA(0OR=1.178,P<0.001),SBP(OR=1.281,P<0.001),DBP(OR=0.781,P=0.036),SUA(OR=1.178,P<0.001)and eGFR(OR=1.122,P<0.001)were independent risk factors for increased cfPWV.Conclusion With age-related decline in eGFR,the decline of arterial elasticity may precede the thickening of carotid intima.Strict control of blood pressure,blood glucose and uric acid may better prevent arteriosclerosis in healthy individuals.

关 键 词：增龄 肾功能 颈股脉搏波传导速度 颈动脉内中膜厚度 

分 类 号：R743.3[医药卫生—神经病学与精神病学]