原发性高血压病人早期肾损伤影响因素的临床研究

余信强; 张苏川

doi:10.13898/j.cnki.issn.1000-2200.2019.02.008

原发性高血压病人早期肾损伤影响因素的临床研究

Study on the influencing factor of early renal damage in patients with primary hypertension

摘要

摘要:
目的探讨原发性高血压病人发生早期肾功能损伤的高危因素。
方法选取原发性高血压病人187例为研究对象，根据尿微量白蛋白/肌酐比值（UACR）分为单纯高血压组116例和高血压肾损组71例，比较2组病人一般临床资料及24 h、日间、夜间收缩压（SBP）和舒张压（DBP），分析原发性高血压病人发生早期肾功能损伤的危险因素。
结果单纯高血压组与高血压肾损组病人的性别、年龄、体质量指数和吸烟、饮酒差异均无统计学意义（P>0.05），单纯高血压组病人的病程明显短于高血压肾损组（P<0.01），在血压与血压变异方面，2组dSBP、dDBP、24 h SBP变异（24hSSD）、24 h DBP变异（24hDSD）、日间SBP变异（dSSD）、日间DBP变异（dDSD）差异均有统计学意义（P<0.05~P<0.01）。以UACR为因变量，以病程、dSBP、dDBP、24hSSD、24hDSD、dSSD、dDSD为自变量，进行多因素logistic回归分析，结果显示，病程、dSBP、24hSSD、24hDSD、dSSD、dDSD均为UACR的独立影响因素（P<0.01）。
结论原发性高血压病人病程、dSBP、24hSSD、24hDSD、dSSD、dDSD均为肾功能损伤的独立危险因素。

Abstract:
ObjectiveTo study the risk factors of early renal damage in patients with primary hypertension.
MethodsOne hundred and eighty-seven patients with primary hypertension were divided into the hypertension group(116 cases) and hypertensive renal damage group(71 cases) according to the urine albumin/creatinine ratio(UACR), the clinical data, 24 h systolic blood pressure(SBP) and diastolic blood pressure(DBP) between two groups were compared, and the risk factors of early renal damage in patients with primary hypertension were analyzed.
ResultsThe differences of gender, age, body mass index, smoking and drinking between two groups were not statistically significant(P>0.05), the disease duration in hypertension group was significantly shorter than that in hypertensive renal damage group(P < 0.01), and the differences of dSBP, dDBP, 24hSSD, 24hDSD, dSSD and dDSD between two groups were statistically significant(P < 0.05 to P < 0.01).The UACR was set as the dependent variable, the disease duration, dSBP, dDBP, 24hSSD, 24hDSD, dSSD and dDSD were set as the independent variable, and the multiple logistic regression analysis showed that the disease duration, dSBP, 24hSSD, 24hDSD, dSSD and dDSD were the independent influencing factors of UACR(P < 0.01).
ConclusionsThe disease duration, dSBP, 24hSSD, 24hDSD, dSSD and dDSD are the independent risk factors of renal function damage in patients with primary hypertension.

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