目的 分析高海拔地区高血压肾损害与尿渗透压、高血压分级及病程相关性.方法 选取2010年3月-2014年12月青海省心脑血管病专科医院心律失常一科诊治高海拔地区高血压患者172例作为研究对象,其中高血压肾损害79例(观察组),单纯高血压患者93例(对照组),观察2组患者尿渗透压、高血压分级及病程的差异.结果 观察组尿微量白蛋白、24h尿蛋白定量和尿渗透压水平均高于对照组(t =8.965、9.589、11.257,P =0.032、0.015、0.021).高血压分级越高,则高血压肾损害发生率越大,差异有统计学意义(x2=33.083,P =0.000),而高血压不同病程之间高血压肾损害比较差异无统计学意义(x2=1.190,P =0.755).经Logistic回归分析,高血压肾损害独立危险因素为尿渗透压(OR =4.132,95％CI 1.234～16.724,P =0.002)和高血压分级(OR =2.994,95％CI 1.111～17.258,P =0.003),而与高血压病程无关(OR =1.112,95％CI 0.234～0.781,P =0.089).结论 高海拔地区高血压肾损害与尿渗透压、高血压分级存在正相关,和高血压病程无关.%Objective To analyze the correlation between renal damage and urinary osmolality,hypertension grade and course of disease in high altitude area.Methods From March 2010 to December 2014,in cardiovascular disease hospital of Qinghai Province,172 cases of arrhythmia patients with hypertension in high altitude region enrolled as the research object,of which 79 cases of hypertensive renal damage(observation group),93 patients with hypertension(control group),urine osmotic pressure,different grade of hypertension and course of 2 group were observed.Results In the control group,the osmotic pressure of water,urinary albumin,urine protein and urine 24h were lower than the average in the observation group(P<0.05);the higher the grade of hypertension,the incidence of hypertensive renal damage was greater,there was a positive correlation between them(x2=33.083,P=0.000),and the renal damage of hypertension and high blood pressure showed no correlation(x2=1.190,P=0.755);the Logistic regression analysis showed that the renal damage of hypertension related factors of urinary osmotic pressure(OR=4.132,95％CI 1.234 to 16.724,P=0.002)and hypertension grade(OR=2.994,95％CI 1.111 to 17.258,P=0.003),and has nothing to do with the duration of hypertension(OR=1.112,95％CI 0.234 to 0.781,P=0.089).Conclusion There is a positive correlation between hypertensive renal damage and urinary osmotic pressure and hypertension in high altitude area,which is not related to the course of hypertension.
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