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目的:探讨随诊间血压变异性对老年高血压伴中度肾功能不全患者预后的影响。方法:选取广州市番禺区何贤纪念医院体检或住院的204例老年高血压伴中度肾功能不全患者作为研究对象,对患者一般情况、病史资料等进行调查,随访24个月。应用多因素线性回归分析方法分析影响随诊间血压变异性的相关因素,采用COX回归分析明确随诊间血压变异性对预后的影响。结果:多因素线性回归分析显示收缩压变异系数与年龄、糖尿病史、心脑血管病史、随访期e GFR变化呈显著正相关(P<0.05),而与随访次数则呈显著负相关(P<0.05)。多因素Cox回归分析显示高收缩压变异性为老年高血压合并中度肾功能不全患者发生全因死亡和非致死性心脑血管事件发生的危险因素(P<0.05)。结论:随诊间血压变异性为老年高血压合并中度肾功能不全患者不良预后的危险因素。
Abstract：Objective: To investigate the impact of visit-to-visit blood pressure variability( BPV) on the prognosis of elderly hypertensive patients with moderate renal insufficientcy. Methods: A total of 204 elderly hypertensive patients with moderate renal insufficiency,who underwent health check-up or were hospitalized in Panyu District He Xian Memorial Hospital of Guangzhou,were included as study subjects. The patients were collected of demographic characteristics and medical record data,and were followed up for 24 months.Multivariate linear regression analysis was used to determine the factors influencing variability of visit-to-visit BPV during follow-up.Cox regression analysis was used to determine the impact of BPV on the prognosis of renal insufficiency.Results: Multivariate linear regression showed that the variation coefficient of systolic blood pressure was positively correlated with age,history of diabetes mellitus,cardiovascular and cerebrovascular diseases,e GFR decline at follow-up( P < 0. 05),but was negatively correlated with the number of follow-ups( P < 0. 05).Multivariate Cox regression found that high systolic BPV was the risk factor of all-cause mortality and non-fatal cardiovascular or cerebrovascular events in elderly hypertensive patients with moderate renal insufficiency( P<0.05). Conclusion: Visit-to-visit BPV during follow-up is a risk factor for poor prognosis in elderly hypertensive patients with moderate renal insufficiency.
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基本信息:
中图分类号:R544.1;R692
引用信息:
[1]卓裕丰,段跃兴,郑栋,等.随诊间血压变异性对老年高血压伴中度肾功能不全患者预后的影响[J].广州医科大学学报,2017,45(06):19-23.
基金信息:
广州市番禺区科技局科研项目(2014-Z03-19);; 广东省科技厅资助项目(2016A020215011)