中国心血管杂志
中國心血管雜誌
중국심혈관잡지
CHINESE JOURNAL OF CARDIOVASOLOGY
2015年
4期
256-261
,共6页
刘建峰%华琦%罗鸿宇%朱玮玮%李敬%王钢
劉建峰%華琦%囉鴻宇%硃瑋瑋%李敬%王鋼
류건봉%화기%라홍우%주위위%리경%왕강
高血压%红细胞分布宽度%估算肾小球滤过率%老年
高血壓%紅細胞分佈寬度%估算腎小毬濾過率%老年
고혈압%홍세포분포관도%고산신소구려과솔%노년
Hypertension%Red blood cell distribution width%Estimated glomerular filtration rate%Aged
目的：探讨老年原发性高血压患者红细胞分布宽度(RDW)与早期肾功能损害的关系。方法入选2014年7~12月首都医科大学宣武医院高血压门诊364例老年原发性高血压患者作为观察组,另连续选取100名同期年龄匹配的体检健康者作为对照组,记录两组年龄、性别、收缩压、舒张压、体质指数(BMI)、空腹血糖(FPG)、三酰甘油(TG)、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)、尿酸、肌酐、尿素氮、尿蛋白定性及血常规等。采用肾脏病饮食改良(MDRD)简化公式计算估算肾小球滤过率(eGFR),根据 eGFR 水平将高血压组患者分为两组：eGFR 下降组( eGFR ﹤90 ml.min -1.1.73 m -2)102例与 eGFR 正常组( eGFR≥90 ml.min -1.1.73 m -2)262例。并比较 RDW、eGFR、BMI 和生化指标等参数在各组间的变化差异,分析 RDW 与eGFR 的相关性。结果(1)与对照组比较,高血压组患者 BMI[(25.84±2.95) kg/ m2比(23.79±3.12) kg/ m2]、 TG [(1.96±1.34) mmol/ L 比(1.58±0.69) mmol/ L ]、血尿酸[(325.37±88.97)mmol/ L比(296.63±80.11) mmol/ L]和 RDW(13.05%±0.87%比12.59%±0.61%)水平升高,HDL-C[(1.43±0.38) mmol/ L 比(1.61±0.33) mmol/ L]和 eGFR[(104.63±28.47) ml.min -1.1.73 m -2比(124.49±25.96)ml.min -1.1.73 m -2]水平下降,差异均有统计学意义(均为 P ﹤0.05)；(2)在高血压患者中,与 eGFR 正常组比较,eGFR 下降组的年龄[(62.6±9.3)岁比(59.9±8.8)岁]、BMI[(26.99±3.05)kg/ m2比(25.39±2.78) kg/ m2]、收缩压[(163.44±15.18) mmHg 比(154.42±12.27)mmHg]、高血压病程[(12.4±3.7)年比(9.8±3.6)年]、血尿酸[(358.84±97.93)mmol/ L比(312.34±81.79)mmol/ L]、肌酐[(87.56±21.16)μmol/ L 比(58.60±11.01)μmol/ L]、尿蛋白阳性率(46.10%比21.00%)及 RDW(13.45%±0.94%比12.90%±0.79%)均升高,而 eGFR[(73.85±12.32)ml.min -1.1.73 m -2比(116.61±23.54)ml.min -1.1.73 m -2]下降,差异均有统计学意义(均为P ﹤0.05)；经 Pearson 相关分析显示,高血压组患者 RDW 与 eGFR 水平呈负相关(r =-0.237,P =0.000)；(3)Logistic 多元回归分析显示,RDW 是 eGFR 的危险因素(OR =1.485,P =0.015)。结论老年原发性高血压患者的 RDW 与 eGFR 呈负相关,RDW 可作为评估老年原发性高血压患者早期肾功能损害的预测因素。
目的：探討老年原髮性高血壓患者紅細胞分佈寬度(RDW)與早期腎功能損害的關繫。方法入選2014年7~12月首都醫科大學宣武醫院高血壓門診364例老年原髮性高血壓患者作為觀察組,另連續選取100名同期年齡匹配的體檢健康者作為對照組,記錄兩組年齡、性彆、收縮壓、舒張壓、體質指數(BMI)、空腹血糖(FPG)、三酰甘油(TG)、總膽固醇(TC)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)、尿痠、肌酐、尿素氮、尿蛋白定性及血常規等。採用腎髒病飲食改良(MDRD)簡化公式計算估算腎小毬濾過率(eGFR),根據 eGFR 水平將高血壓組患者分為兩組：eGFR 下降組( eGFR ﹤90 ml.min -1.1.73 m -2)102例與 eGFR 正常組( eGFR≥90 ml.min -1.1.73 m -2)262例。併比較 RDW、eGFR、BMI 和生化指標等參數在各組間的變化差異,分析 RDW 與eGFR 的相關性。結果(1)與對照組比較,高血壓組患者 BMI[(25.84±2.95) kg/ m2比(23.79±3.12) kg/ m2]、 TG [(1.96±1.34) mmol/ L 比(1.58±0.69) mmol/ L ]、血尿痠[(325.37±88.97)mmol/ L比(296.63±80.11) mmol/ L]和 RDW(13.05%±0.87%比12.59%±0.61%)水平升高,HDL-C[(1.43±0.38) mmol/ L 比(1.61±0.33) mmol/ L]和 eGFR[(104.63±28.47) ml.min -1.1.73 m -2比(124.49±25.96)ml.min -1.1.73 m -2]水平下降,差異均有統計學意義(均為 P ﹤0.05)；(2)在高血壓患者中,與 eGFR 正常組比較,eGFR 下降組的年齡[(62.6±9.3)歲比(59.9±8.8)歲]、BMI[(26.99±3.05)kg/ m2比(25.39±2.78) kg/ m2]、收縮壓[(163.44±15.18) mmHg 比(154.42±12.27)mmHg]、高血壓病程[(12.4±3.7)年比(9.8±3.6)年]、血尿痠[(358.84±97.93)mmol/ L比(312.34±81.79)mmol/ L]、肌酐[(87.56±21.16)μmol/ L 比(58.60±11.01)μmol/ L]、尿蛋白暘性率(46.10%比21.00%)及 RDW(13.45%±0.94%比12.90%±0.79%)均升高,而 eGFR[(73.85±12.32)ml.min -1.1.73 m -2比(116.61±23.54)ml.min -1.1.73 m -2]下降,差異均有統計學意義(均為P ﹤0.05)；經 Pearson 相關分析顯示,高血壓組患者 RDW 與 eGFR 水平呈負相關(r =-0.237,P =0.000)；(3)Logistic 多元迴歸分析顯示,RDW 是 eGFR 的危險因素(OR =1.485,P =0.015)。結論老年原髮性高血壓患者的 RDW 與 eGFR 呈負相關,RDW 可作為評估老年原髮性高血壓患者早期腎功能損害的預測因素。
목적：탐토노년원발성고혈압환자홍세포분포관도(RDW)여조기신공능손해적관계。방법입선2014년7~12월수도의과대학선무의원고혈압문진364례노년원발성고혈압환자작위관찰조,령련속선취100명동기년령필배적체검건강자작위대조조,기록량조년령、성별、수축압、서장압、체질지수(BMI)、공복혈당(FPG)、삼선감유(TG)、총담고순(TC)、저밀도지단백담고순(LDL-C)、고밀도지단백담고순(HDL-C)、뇨산、기항、뇨소담、뇨단백정성급혈상규등。채용신장병음식개량(MDRD)간화공식계산고산신소구려과솔(eGFR),근거 eGFR 수평장고혈압조환자분위량조：eGFR 하강조( eGFR ﹤90 ml.min -1.1.73 m -2)102례여 eGFR 정상조( eGFR≥90 ml.min -1.1.73 m -2)262례。병비교 RDW、eGFR、BMI 화생화지표등삼수재각조간적변화차이,분석 RDW 여eGFR 적상관성。결과(1)여대조조비교,고혈압조환자 BMI[(25.84±2.95) kg/ m2비(23.79±3.12) kg/ m2]、 TG [(1.96±1.34) mmol/ L 비(1.58±0.69) mmol/ L ]、혈뇨산[(325.37±88.97)mmol/ L비(296.63±80.11) mmol/ L]화 RDW(13.05%±0.87%비12.59%±0.61%)수평승고,HDL-C[(1.43±0.38) mmol/ L 비(1.61±0.33) mmol/ L]화 eGFR[(104.63±28.47) ml.min -1.1.73 m -2비(124.49±25.96)ml.min -1.1.73 m -2]수평하강,차이균유통계학의의(균위 P ﹤0.05)；(2)재고혈압환자중,여 eGFR 정상조비교,eGFR 하강조적년령[(62.6±9.3)세비(59.9±8.8)세]、BMI[(26.99±3.05)kg/ m2비(25.39±2.78) kg/ m2]、수축압[(163.44±15.18) mmHg 비(154.42±12.27)mmHg]、고혈압병정[(12.4±3.7)년비(9.8±3.6)년]、혈뇨산[(358.84±97.93)mmol/ L비(312.34±81.79)mmol/ L]、기항[(87.56±21.16)μmol/ L 비(58.60±11.01)μmol/ L]、뇨단백양성솔(46.10%비21.00%)급 RDW(13.45%±0.94%비12.90%±0.79%)균승고,이 eGFR[(73.85±12.32)ml.min -1.1.73 m -2비(116.61±23.54)ml.min -1.1.73 m -2]하강,차이균유통계학의의(균위P ﹤0.05)；경 Pearson 상관분석현시,고혈압조환자 RDW 여 eGFR 수평정부상관(r =-0.237,P =0.000)；(3)Logistic 다원회귀분석현시,RDW 시 eGFR 적위험인소(OR =1.485,P =0.015)。결론노년원발성고혈압환자적 RDW 여 eGFR 정부상관,RDW 가작위평고노년원발성고혈압환자조기신공능손해적예측인소。
Objective To investigate the correlation between red blood cell distribution width (RDW) and early-stage renal function damage in elderly patients with essential hypertension. Methods A total of 364 elderly patients with essential hypertension were recruited from July 2014 to December 2014 in hypertension outpatients of Xuanwu Hospital as the hypertension group, while 100 consecutive healthy subjects were enrolled as the control group. Age, gender, SBP, DBP, BMI, FPG, TG, TC, LDL-C, HDL-C, UA, SCr, BUN, urine protein consentration and complete blood count (CBC) were documented in all individuals. Renal function was evaluated by estimated glomerular filtration rate (eGFR) and calculated by MDRD formula in 364 elderly patients with hypertension, whom were further divided into two groups according to eGFR values: renal function deficient group (eGFR ﹤ 90 ml.min - 1.1. 73 m - 2 , n = 102) and non-deficient group (eGFR≥90 ml.min - 1.1. 73 m - 2 , n = 262). Results (1) Compared with control group, the hypertension group was significantly higher in BMI [(25. 84 ± 2. 95) kg/ m2 vs. (23. 79 ± 3. 12) kg/ m2 ], TC [(1. 96 ± 1. 34) mmol/ L vs. (1. 58 ± 0. 69) mmol/ L], UA [(325. 37 ± 88. 97) mmol/ L vs. (296. 63 ± 80. 11)mmol/ L] and RDW (13. 05% ± 0. 87% vs. 12. 59% ± 0. 61% ), but significantly lower in HDL-C [(1. 43 ± 0. 38) mmol/ L vs. (1. 61 ± 0. 33) mmol/ L], eGFR [(104. 63 ± 28. 47) ml.min - 1. 1. 73 m - 2 vs. (124. 49 ± 25. 96) ml.min - 1.1. 73 m - 2 ] (all P ﹤ 0. 05). (2) In hypertensive patients, eGFR abnormal group showed significant differences compared with eGFR normal group in follows: age [(62. 6 ± 9. 3)years old vs. (59. 9 ± 8. 8) years old], BMI [(26. 99 ± 3. 05) kg/ m2 vs. (25. 39 ± 2. 78) kg/ m2 ], SBP [(163. 44 ± 15. 18) mmHg vs. (154. 42 ± 12. 27) mmHg], hypertension course [(12. 4 ± 3. 7)years vs. (9. 8 ± 3. 6)years], UA [(358. 84 ± 97. 93) mmol/ L vs. (312. 34 ± 81. 79) mmol/ L], SCr [(87. 56 ± 21. 16) μmol/ L vs. (58. 60 ± 11. 01) μmol/ L], urine protein positive rate (46. 10% vs. 21. 00% ) and RDW (13. 45% ± 0. 94% vs. 12. 90% ± 0. 79% ) were significantly higher, while eGFR [(73. 85 ± 12. 32) ml.min - 1.1. 73 m - 2 vs. (116. 61 ± 23. 54) ml.min - 1.1. 73 m - 2 ]significantly lower (all P ﹤ 0. 05). Pearson correlation analysis showed that RDW was negatively correlated with eGFR (r = -0. 237, P = 0. 000). Logistic multivariate regression analysis showed that RDW was an independent predictor of eGFR (OR = 1. 485, P = 0. 015). Conclusions RDW is negatively correlated with eGFR in elderly patients with essential hypertension. RDW may be used as a predictive factor of early renal damage in elderly patients with essential hypertension.
