老年原发性高血压患者踝臂指数分析
Chinese Journal of Geriatric Heart Brain and Vessel Diseases(2012)
Abstract
目的 探讨老年原发性高血压患者左心室肥厚(LVH)与估算的肾小球滤过率(eGFR)及踝臂指数(ABI)的关系.方法 选择215例老年原发性高血压患者,根据ABI<0.9定义为外周动脉疾病(PAD),并分为PAD组51例和非PAD组164例,2组均做超声心动图检查、测血肌酐、ABI、血脂、糖化血红蛋白(HbA1c)和血压等,并收集相关影响因素,根据肌酐计算eGFR.分析LVH与eGFR及ABI的关系.结果 与非PAD组比较,PAD组收缩压明显增高,eGFR明显减少(P<0.05);收缩压是ABI的独立危险因素(OR=1.023,95%CI:1.001~1.046,P<0.05).左心室重量指数与eGFR、LDLC呈负相关(r=-0.237、P<0.01,r=-0.157、P<0.05).eGFR(OR=3.016,95%CI:-0.428~-0.090,P<0.01)、LDL-C和收缩压为LVH的危险因素,ABI降低对LVH无明显影响.结论 老年原发性高血压患者伴PAD时,血压升高、eGFR下降,eGFR与LVH有关,可能是LVH的危险因素之一,LVH时大动脉硬化较无高血压患者严重.
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Key words
glomerular filtration rate,hypertrophy,left ventricular,hemoglobin A,hypertension,echocardiography,risk factors,glycosylated
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