湖北省钟祥市长寿老人舒张压与肾功能的相关性
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(武汉大学中南医院老年病科,武汉 430071)

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R544.1;R592

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湖北省老龄办重点项目研究基金(Bhlb2017004)


Correlation of diastolic blood pressure and renal function in longevous elderly of Zhongxiang City, Hubei province
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(Department of Geriatrics, Zhongnan Hospital, Wuhan University, Wuhan 430071,China)

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    摘要:

    目的 对湖北省钟祥市长寿老人的舒张压与肾功能进行相关性分析,探讨适合长寿老人的舒张压目标值。方法 于2013年1月至2019年3月对湖北省钟祥市长寿老人多次进行面对面走访调研,纳入≥90岁长寿老人共309名。根据是否罹患高血压分为高血压组和正常血压组。采用SPSS 23.0统计软件进行数据分析。采用X2检验、Mann-Whitney U检验及t检验分别比较2组间临床指标的差异。采用Pearson相关性分析及多元线性回归模型分析肾小球滤过率(eGFR)与临床指标的相关性,进一步将舒张压按每10mmHg(1mmHg=0.133kPa)分层为60~70、71~80、81~90、91~100、101~110、111~120mmHg,并采用多元线性回归模型分析舒张压分层与eGFR的相关性。结果 309名长寿老人高血压患病率高达80.6%(249/309),但治疗率较低为20.1%(50/249),CKD患病率为28.2%(87/309)。高血压组血尿素氮、血肌酐、CKD患病率均低于正常血压组,差异均有统计学意义(均P<0.05);eGFR、心脏疾病患病率均高于正常血压组,差异均有统计学意义(均P<0.05)。Pearson相关性分析显示,eGFR与空腹血糖呈负相关,与年龄、舒张压及总胆固醇呈正相关,差异均有统计学意义(r=-0.120,0.160,0.168,0.148;均P<0.05)。多元线性回归分析显示,eGFR与年龄、舒张压、总胆固醇呈正相关(β=0.721,0.238,3.537;P<0.05)。以舒张压在60~70mmHg为参照,舒张压在81~90、91~100mmHg时,eGFR逐渐升高。结论 湖北省钟祥市长寿老年人高血压患病率高、治疗率低,舒张压控制在81~100mmHg时,能保证肾脏良好的血流灌注,长寿老人的舒张压降压目标值可适当放宽。

    Abstract:

    Objective To analyze the correlations between diastolic blood pressure and renal function in long-lived elderly living in Zhongxiang City in order to explore an appropriate target value of diastolic blood pressure for them. Methods During January 2013 to March 2019,309 long-lived residents (≥90 years old) in Zhongxiang City were recruited in this study by repetitive face-to-face visits. They were divided into hypertension (HT) group and normal blood pressure (NT) group according to whether they suffered fron hypertension. SPSS statistics 23.0 was used for statistical analysis. Data comparison between two groups was perfomed using Mann-Whitney U test, t test orχ2 test depending on data type. The correlation of estimated glomerular filtration rate (eGFR) with clinical indicators was analyzed by Pearson correlation analysis and multiple linear regression model analysis. Further, the diastolic blood pressure was stratified by every 10 mmHg (1 mmHg=0.133 kPa) into 60-70,71-80,81-90,91-100, 101-110 and 111-120 mmHg, and the correlation between diastolic blood pressure stratification and eGFR was analyzed by multiple linear regression. Results These subjects exhibited a high hypertension prevalence of 80.6%(249/309), a low treatment rate of 20.1%(50/249), and an incidence of chronic kidney disease (CKD) of 28.2%(87/309). The HT group had significantly lower urea nitrogen and creatinine levels and CKD prevalence (P<0.05), but significantly higher eGFR and heart disease prevalence (P<0.05) when compared with the NT group. Pearson correlation analysis showed that eGFR was negatively correlated with fasting blood glucose (r=-0.120, P<0.05) and positively with age, diastolic blood pressure and total cholesterol (r=0.160,0.168,0.148; P<0.05). Multiple linear regression analysis indicated that eGFR was positively correlated with age, diastolic blood pressure and total cholesterol (β=0.721,0.238,3.537; P<0.05). With diastolic blood pressure at 60-70 mmHg as the reference, eGFR was increased in the elderly with diastolic blood pressure at 81-90 and 91-100 mmHg. Conclusion The long-lived elderly living in Zhongxiang City have a high hypertension prevalence and a low treatment rate. Good renal blood perfusion could be guaranteed when the diastolic blood pressure is controlled at 81-100 mmHg. The target value of diastolic blood pressure can be appropriately broadened for the long-lived elderly.

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彭姣,王桦,张艳芳,董昱,尹倩.湖北省钟祥市长寿老人舒张压与肾功能的相关性[J].中华老年多器官疾病杂志,2022,21(3):170~174

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  • 收稿日期:2021-05-27
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  • 在线发布日期: 2022-03-28
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