H型高血压与慢性肾脏病的相关性研究  

Correlationstudy of H-type hypertension and chronic kidney disease

作　　者：龙田瑶 郑刘扬奕 丁梓豪 禹彤 洪秀琴 LONG Tian-yao;ZHENG Liu-yang-yi;DING Zi-hao;YU Tong;HONG Xiu-qin(The First Affiliated Hospital with Hunan Normal University,Changsha,Hunan 410005,China;不详)

机构地区：[1]湖南师范大学附属第一医院,湖南长沙410005 [2]湖南师范大学医学院

出　　处：《现代预防医学》2024年第16期3048-3054,共7页Modern Preventive Medicine

基　　金：国家自然科学基金资助项目(81773530);湖南省自然科学基金(2020JJ4047);湖南省教育厅(22A0078)。

摘　　要：目的探讨H型高血压与慢性肾脏病(chronic kidney disease,CKD)之间的关系,为慢性肾脏病的防治提供科学依据。方法2021年12月-2022年12月于湖南省人民医院肾内科随机收集CKD患者257例,体检科收集257例患者为对照组。收集所有研究对象的一般人口学特征、生活习惯、疾病史以及临床指标等数据。通过单因素及多因素分析方法分析CKD的流行现状和影响因素、H型高血压与CKD的关系。构建交互作用模型分析同型半胱氨酸(homocysteine,Hcy)、高血压对CKD发病的交互作用。通过亚组分析探索H型高血压与相关影响因素对CKD的影响。结果CKD组和对照组之间一般人口学特征和临床指标的单因素分析结果显示:两组的年龄、民族、文化程度、家庭人均收入、运动情况、睡眠时间、BMI、H型高血压史、甘油三酯(Triglyceride,TG)、高密度脂蛋白胆固醇(Highdensity lipoprotein cholesterol,HDL)、白蛋白(albumin,ALB)、肾小球滤过率(glomerular filtration rate,GFR)、血尿素氮(Blood urea nitrogen,BUN)、尿酸(Uric acid,UA)、Hcy、总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、C反应蛋白(C-reactive protein,CRP)水平存在差异(P<0.05)。二分类logistic回归分析结果显示,调整调整年龄、民族、文化程度、家庭人均收入、运动情况、睡眠时间、BMI、TG、HDL、ALB、GFR、BUN、UA、TBIL、DBIL、CRP等混杂因素后,H型高血压患者发生CKD的风险是非H型高血压的2.333倍(OR=2.333,95%CI:1.365~3.989,P=0.002)。高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)与高血压的交互作用结果提示:HHcy与高血压存在正向相加交互作用,无相乘交互作用。H型高血压与年龄、文化程度、家庭年均人收入、睡眠时间对CKD的发病存在交互作用(P<0.05)。结论H型高血压是CKD的危险因素,且HHcy和高血压对CKD的影响具有正向的协同作用。Objective To explore the relationship between H-type hypertension and chronic kidney disease(CKD)and provide scientific basis for the prevention and treatment of chronic kidney disease.Methods From December 2021to December 2022,257 patients with CKD were randomly collected from the Department of Nephrology of Hunan Provincial People's Hospital,and 257 patients were collected in the physical examination department as the control group.Data on general demographic characteristics,lifestyle habits,disease history,and clinical indicators were collected for all study subjects.The epidemic status and influencing factors of CKD,and the relationship between H-type hypertension and CKD were analyzed by univariate and multivariate analysis methods.An interaction model was constructed to analyze the interaction effect of homocysteine(Hcy)and hypertension on the onset of CKD.The effect of H-type hypertension and related influencing factors on CKD were explored by subgroup analysis.Results tsThe results of univariate analysis of general demographic characteristics and clinical indicators between CKD and control groups showed:age,ethnicity,educational level,per capita income,exercise status,sleep duration,BMI,history of H-type hypertension,triglycerides(TG),High-density lipoprotein cholesterol(HDL),albumin(ALB),glomerular filtration rate(GFR),blood urea nitrogen(BUN),uric acid(UA),Hcy,total bilirubin(TBIL),direct bilirubin(DBIL),C reactive protein(CRP)levels(P<0.05).Dichotomized Logistic regression analysis showed that the risk of CKD,adjusted for age,nationality,educational level,family income,exercise,sleep duration,BMI,TG,HDL,ALB,GFR,BUN,UA,TBIL,CRP was 2.333 times higher than in those without H-type hypertension(OR=2.333,95%CI:1.365-3.989,P=0.002).The interaction results between hyperhomocysteinemia(HHcy)and hypertension suggested that there was a positive additive interaction between HHcy and hypertension,with no multiplicative interaction.There was an interaction between H-type hypertension and age,educational level,avera

关 键 词：同型半胱氨酸 高血压 慢性肾脏病 病例对照研究 影响因素分析 

分 类 号：R544.1[医药卫生—心血管疾病]