老年高血压患者血清TSH、FT4水平与血压变异性及肾损伤的相关性  

Association of serum TSH,FT4 levels with blood pressure variability and renal injury in elderly patients with hypertension

作　　者：王妙君 周晟劼 WANG Miao-jun;ZHOU Sheng-jie(Department of Cardiology,Dongtai People's Hospital,Dongtai,Jiangsu,224200,China)

机构地区：[1]东台市人民医院心血管内科,江苏东台224200

出　　处：《心血管康复医学杂志》2024年第5期541-545,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：江苏省卫计委2015年度指导性科研课题(Z201530)。

摘　　要：目的:研究老年高血压患者血清促甲状腺激素(TSH)、游离甲状腺素(FT4)水平与血压变异性及肾损伤的相关性。方法:回顾性纳入2019年2月~2021年1月于东台市人民医院就诊的110例老年高血压患者(高血压组),另选择基线资料匹配、同期于本院行健康体检者105例(对照组)。比较两组血清TSH、FT4水平,血压变异性指标[24h收缩压变异系数(24hSCV)、24h舒张压变异系数(24hDCV)、日间收缩压变异系数(dSCV)、日间舒张压变异系数(dDCV)、夜间收缩压变异系数(nSCV)、夜间舒张压变异系数(nDCV)]以及肾损伤指标[尿微量白蛋白与肌酐比值(UACR)、估测肾小球滤过率(eGFR)、β2-微球蛋白(β2-MG)]。采用Pearson法分析TSH、FT4与血压变异性指标、肾损伤指标的相关性;高血压组根据肾损伤情况分为肾损伤组(38例)和正常组(72例),比较两组血清TSH、FT4水平。结果:与对照组比较,高血压组TSH水平,24hSCV、24hDCV、dSCV、dDCV、nSCV、nDCV,UACR、β2-MG水平均显著升高,FT4水平和eGFR均显著降低(P均<0.001)。Pearson相关性分析结果显示,TSH水平与血压变异性各指标均呈正相关(r=0.457~0.621,P均<0.001),FT4水平与血压变异性各指标均呈负相关(r=-0.535~-0.402,P均<0.001);TSH与UACR、β2-MG均呈正相关(r=0.594、0.644,P均<0.001),与eGFR呈负相关(r=-0.420,P<0.001);FT4水平与UACR、β2-MG均呈负相关(r=-0.561、-0.622,P均<0.001),与eGFR呈正相关(r=0.409,P<0.001)。与正常组比较,肾损伤组TSH水平显著升高,FT4水平显著降低(P均<0.001)。结论:老年高血压患者血清TSH水平显著升高、FT4水平显著降低,二者与血压变异性及肾损伤存在显著相关性。Objective:To study the association of serum thyroid stimulating hormone(TSH),free thyroxine(FT4)levels with blood pressure variability(BPV)and renal injury in elderly patients with hypertension.Methods:A total of 110 elderly patients with hypertension treated in Dongtai People's Hospital between February 2019 and January 2021 were retrospectively enrolled as hypertension group,while another 105 healthy subjects with corresponding baseline data undergoing physical examination simultaneously in our hospital were regarded as control group.Serum TSH and FT4 levels,BPV indexes[24h systolic blood pressure coefficient of variant(24hSCV),24h diastolic blood pressure coefficient of variant(24hDCV),daytime systolic blood pressure coefficient of variant(dSCV),daytime diastolic blood pressure coefficient of variant(dDCV),nighttime systolic blood pressure coefficient of variant(nSCV)and nighttime diastolic blood pressure coefficient of variant(nDCV)]and renal injury indexes[urinary albumin/creatinine ratio(UACR),estimated glomerular filtration rate(eGFR)andβ2-microglobulin(β2-MG)]were compared between two groups.Pearson method was used to analyze the association of TSH and FT4 levels with BPV and renal injury indexes;according to renal injury condition,hypertension group was divided into renal injury group(n=38)and normal group(n=72),then serum TSH and FT4 levels were compared between two groups.Results:Compared with control group,hypertension group showed a significant rise in TSH level,24hSCV,24hDCV,dSCV,dDCV,nSCV,nDCV,UACR andβ2-MG levels,and significant reductions in FT4 level and eGFR(P<0.001 all).Pearson correlation analysis indicated that TSH level was positively correlated with all BPV indexes(r=0.457~0.621,P<0.001 all),while FT4 level was inversely correlated with all BPV indexes(r=-0.535~-0.402,P<0.001 all);TSH was positively correlated with UACR andβ2-MG(r=0.594,0.644,P<0.001 both),and inversely correlated with eGFR(r=-0.420,P<0.001);FT4 level was inversely correlated with UACR andβ2-MG(r=-0.561,-0.622,P<0.001

关 键 词：高血压 老年人 促甲状腺素 

分 类 号：R544.109[医药卫生—心血管疾病]