老年原发性高血压合并慢性肾病患者的危险因素分析

摘要

目的 了解老年原发性高血压(EH)住院患者慢性肾病(CKD)检出率,分析相关影响因素.方法 选择确诊的977例EH患者,分为老年EH组575例和非老年EH组402例,同期选择健康体检者4610例为老年对照组,回顾分析CKD的影响因素.结果 老年EH组尿蛋白和估算肾小球滤过率(eGFR)下降比例高于非老年EH组(28.5％ vs 11.4％、18.3％ vs 4.5％,P＜0.05);老年EH组CKD检出率高于非老年EH组和老年对照组(33.7％ vs 12.4％和3.9％,P＜0.05,P＜0.01);收缩压每升高20 mm Hg(1 mm Hg=0.133 kPa),CKD检出率明显增加(P＜0.05).老年EH组合并CKD的危险因素为糖尿病、年龄、血尿酸、收缩压水平(OR=1.702、1.056、1.013、1.007,P＜0.01).结论 住院老年EH患者CKD检出率高于非老年,其发病与血糖、血尿酸及血压水平有关.%Objective To analyze the risk factor for chronic kidney disease (CKD) in elderly essential hypertension (EH) patients.Methods A total of 977 EH patients were divided into elderly EH group (n=575) and non-elderly EH group (n=402) with 4610 subjects undergoing physical examination served as a control group in this study.The incidence of and risk factors for CKD were retrospectively analyzed.Results The detection rate of urinary protein and declined eGFR was higher in elderly EH group than in non-elderly EH group (28.5％ vs 11.4％,18.3％ vs 4.5％,P＜0.05).The detection rate of CKD was higher in elderly EH group than in non-elderly EH group and control group (33.7％ vs 12.4％,33.7％ vs 3.9％,P＜0.05,P＜0.01).With the increase of SBP every 20 mm Hg,the detection rate of CKD increased obviously (P＜0.05).The risk factor for CKD was DM followed by age,high serum uric acid level and SBP in elderly EH patients (OR=1.702,1.056,1.013,1.007,P＜0.01).Conclusion The detection rate of CKD is higher in elderly EH patients than in non-elderly EH patients.The incidence of CKD is related with blood glucose,serum uric acid level and blood pressure in elderly EH patients.