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[1]卓兴峰,翁志强,彭永平,等.原发性高血压患者动态脉压指数与早期肾损伤指标的关系[J].医学研究与战创伤救治(原医学研究生学报),2020,22(2):129-132.[doi:10.3969/j.issn.1672-271X.2020.02.004]
　ZHUO Xing feng,WENG Zhi qiang,PENG Yong ping,et al.The relationship between pulse pressure index and early injury in essential hypertensive patients[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(2):129-132.[doi:10.3969/j.issn.1672-271X.2020.02.004]
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原发性高血压患者动态脉压指数与早期肾损伤指标的关系()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第22卷
期数:
2020年2期
页码:
129-132
栏目:
临床研究
出版日期:
2020-03-11

文章信息/Info

Title:
The relationship between pulse pressure index and early injury in essential hypertensive patients
作者:
卓兴峰; 翁志强; 彭永平; 刘正钊; 钟勇
作者单位：210002 南京，南京大学医学院附属金陵医院（东部战区总医院）门诊部（卓兴峰、翁志强、钟勇），心脏内科（彭永平），全军肾脏病研究所（刘正钊）
Author(s):
ZHUO Xingfeng1;  WENG Zhiqiang1;  PENG Yongping2;  LIU Zhengzhao3;  ZHONG Yong1
(1. Department of Outpatient,2.Department of Cardiology,3. Department of Nephrology, Jinling Hospital Affiliated to Medical School of Nanjing University/General Hospital of Eastern Theater Command, PLA, Nanjing 210002,Jiangsu, China)
关键词:
原发性高血压;  动态脉压指数;  肾损伤;  血清胱抑素C;  动态血压监测;  肾小球滤过率
Keywords:
essential hypertension;  ambulatory pulse pressure index;  renal impairment;  serum cystatin C;  ambulatory blood pressure monitoring;  glomerular filtration rate
分类号:
R544.1
DOI:
10.3969/j.issn.1672-271X.2020.02.004
文献标志码:
A
摘要:
目的探讨监测原发性高血压患者动态脉压指数(PPI)对早期肾损害预测的意义。方法选取2017年5月至2019年3月东部战区总医院心内科收治的175例原发性高血压患者为研究对象。患者入院后进行动态血压监测（ABPM），计算PPI，按结果将患者按PPI值分为低指数组（PPI≤0.40）62例和高指数组（PPI＞0.40）113例2组。检测生化指标，包括血清胱抑素C（CysC）、血糖、血脂、血尿素氮(BUN)、血肌酐(SCr)等，评估肾小球滤过率(eGFR)。采用偏相关分析进行相关性研究，应用Logistic回归模型分析相关因素。结果低指数组年龄、病程、CysC均低于高指数组，eGFR高于高指数组，差异均有统计学意义（P<0.05）。而2组在性别、吸烟/饮酒史、BMI、血糖及血脂指标、BUN、SCr指标方面比较差异无统计学意义（P＞0.05）。偏相关分析控制年龄、病程因素后显示，PPI与eGFR呈负相关（r=-0.750，P<0.001），与CysC呈正相关（r=0.765，P<0.001）。多因素Logistic 回归分析显示，年龄、eGFR、CysC是PPI的风险因素（P<0.05）。结论PPI与原发性高血压患者eGFR、CysC指标密切相关，是预测原发性高血压患者早期肾功能受损的重要指标。临床应重视PPI的变化，早期控制肾功能受损。
Abstract:
ObjectiveTo study the predictive value of ambulatory pulse pressure index(PPI) monitoring on the early renal impairment in patients with essential hypertension.MethodsA total of 175 patients with essential hypertension in Cardiology Department from May, 2018 to March 2019 were enrolled. Twentyfour hours’ ambulatory blood pressure was monitored in patients after admission, and to calculate the PPI on the basis of 24h ambulatory blood pressure. Patients with PPI≤0.40 were enrolled as Low index group, patients with PPI＞0.40 were enrolled as High index group.Blood biochemical indicator detection was conducted, including Serum cystatin C（CysC）, blood glucose, serum lipids related indicators, blood urea nitrogen(BUN) and serum creatinine(SCr), and glomerular filtration rate(GFR) was estimated.ResultsAge, hypertension duration and CysC in Low index group were significantly lower than those in High index group（P<0.05）, but GFR were significantly higher in Low index group（P<0.05）. There was no significant difference ingender, smoking/drinking history, body mass Index, blood glucose, serum lipids related indicators, BUN and SCr between the two groups（P＞0.05）.Partial correlations test showed that PPI was positively correlated with CysC (r=0.765，P<0.001) , but negatively correlated with eGFR（r=-0.750，P<0.001）.Multivariate Logistic regression analysis showed that age, eGFR and CysC were influencing factors for PPI in essential hypertension patients.ConclusionThe PPI is closely related to the levels of eGFR，CysCin patients with essential hypertension, and PPI can be used as a reference index of the early renal impairment. The PPI should be monitored carefully inessential hypertension patients to prevent the renal impairment.

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备注/Memo

备注/Memo:
基金项目：全军医药卫生科研基金面上项目（CNJ14C003）
更新日期/Last Update: 2020-03-11