赵海燕, 李春慧, 赵华灵, 宋路, 杨静, 阮春雨, 崔凯, 魏国清, 郑晓明, 吴云涛. 24小时动态收缩压与老年人肾小球滤过率的关联性研究[J]. 临床肾脏病杂志, 2017, 17(1): 45-49. DOI: 10.3969/j.issn.1671-2390.2017.01.010
    引用本文: 赵海燕, 李春慧, 赵华灵, 宋路, 杨静, 阮春雨, 崔凯, 魏国清, 郑晓明, 吴云涛. 24小时动态收缩压与老年人肾小球滤过率的关联性研究[J]. 临床肾脏病杂志, 2017, 17(1): 45-49. DOI: 10.3969/j.issn.1671-2390.2017.01.010
    ZHAO Hai-yan, LI Chun-hui, ZHAO Hua-ling, SONG Lu, YANG Jing, RUAN Chun-yu, CUI Kai, WEI Guo-qing, ZHENG Xiao-ming, WU Yun-tao. Correlation between 24-h ambulatory systolic blood pressure and glomeruar filtration rate among the elder[J]. Journal of Clinical Nephrology, 2017, 17(1): 45-49. DOI: 10.3969/j.issn.1671-2390.2017.01.010
    Citation: ZHAO Hai-yan, LI Chun-hui, ZHAO Hua-ling, SONG Lu, YANG Jing, RUAN Chun-yu, CUI Kai, WEI Guo-qing, ZHENG Xiao-ming, WU Yun-tao. Correlation between 24-h ambulatory systolic blood pressure and glomeruar filtration rate among the elder[J]. Journal of Clinical Nephrology, 2017, 17(1): 45-49. DOI: 10.3969/j.issn.1671-2390.2017.01.010

    24小时动态收缩压与老年人肾小球滤过率的关联性研究

    Correlation between 24-h ambulatory systolic blood pressure and glomeruar filtration rate among the elder

    • 摘要: 目的 探讨24 h动态收缩压与老年人肾小球滤过率(glomeruar filtration rate,GFR)的关联。方法 2006~2007年第一次对开滦集团公司在职及离退休职工进行健康体检,此后分别于2008~2009、2010~2011年进行第二、三次健康体检,并于第三次体检时整群随机抽取年龄 ≥60岁的开滦集团离退休员工2 814例进行诊室血压测量、动态血压监测等检查。符合入选标准的有2 464例,24 h动态收缩压及肾小球滤过率资料均完整者1 405例,并根据24h收缩压、日间收缩压、夜间收缩压三分位数将研究对象分别分为第一分位组、第二分位组、第三分位组。采用多因素线性回归分析24h收缩压、日间收缩压、夜间收缩压与肾小球滤过率估计值(estimated glomeruar filtration rate,eGFR)的关联。结果 随着24h收缩压、日间收缩压、夜间收缩压升高,eGFR呈降低趋势,但差异无统计学意义(P>0.05)。校正年龄、性别后的偏相关分析显示:24h收缩压与eGFR呈负相关(r=-0.056,P=0.035),日间收缩压(r=-0.051,P=0.056)、夜间SBP(r=-0.052,P=0.050)与eGFR的相关性无统计学差异;诊室收缩压与eGFR呈负相关(r=-0.074,P=0.005)。多因素线性回归分析显示:校正混杂因素后,24h收缩压、日间收缩压、夜间收缩压与eGFR之间的线性关系无统计学差异(B=-0.28、-0.14、-0.34,P=0.619、0.798、0.521),而诊室收缩压与eGFR呈线性负相关(P<0.05)。结论 24h收缩压、日间收缩压、夜间收缩压与GFR无关联,而诊室收缩压与GFR呈负相关,积极密切监测血压并将血压保持在较低的稳定水平对预防和延缓肾功能下降是必要的。

       

      Abstract: Objective To investigate the correlation between the 24h ambulatory systolic blood pressure (SBP) and estimated glomeruar filtration rate (eGFR) in the elder.Methods A total of 2464 participants who were more than or equal to 60 years old were selected with random sampling in accordance with the inclusion criteria from the retired workers in Tangshan Kailuan Company. Finally, 1405 participants were enrolled, and the correlation between SBP and eGFR was analyzed. Multiple linear regression analysis was used to analyze the correlation between the 24h, daytime, nightime SBP and eGFR, respectively.Results The observation population was divided into three groups according to the tertiles of 24h, daytime, nightime SBP, respectively. With the increases of SBP, eGFR had increasing trend, but there was no significant difference.Partial correlation analysis showed negative association between 24h SBP and eGFR (r=-0.056, P=0.035), and no significant difference was found between daytime, nightime SBP and eGFR.Multiple linear regression analysis showed that after adjusting for confounding factors, the 24h, daytime, nightime SBP was not associated with eGFR significantly (B=-0.28, -0.14 and -0.34; P=0.619, 0.798 and 0.521). However, the clinic SBP was associated with eGFR negatively and linearly (P<0.05).Conclusions The 24h, daytime, nightime SBP was not significantly associated with eGFR, but there was negative association between clinic SBP and GFR. Closely monitoring blood pressure and keeping it at a low and steady level is essential to prevent and delay renal function decline.

       

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