摘要
目的探讨原发性高血压病患者动态血压均值、动态脉压(24 hPP)、动态脉压指数(PPI)与血清胱抑素C(CysC)的相关性。方法选取2012年3月—2013年2月收住昆明医科大学附属甘美医院心内科的原发性高血压病患者270例为研究对象,进行动态血压监测,获取24 h平均收缩压(24 hSBP)、24 h平均舒张压(24 hDBP)、24 hPP及PPI。根据PPI的中位数将患者分为A、B两组,A组135例,PPI<0.437;B组135例,PPI≥0.437。测定CysC、血肌酐(Scr)、尿素氮(BUN)、血糖、血脂等实验室检查指标,使用MDRD方程计算评估肾小球滤过率(eGFR)。比较两组所检测指标的差别,采用偏相关和多元线性逐步回归分析动态血压均值、24 hPP、PPI与CysC的相关性。结果 B组的CysC、Scr水平较A组升高,eGFR较A组降低,差异均有统计学意义(P<0.05)。B组的PPI、24 hSBP、24 hPP较A组升高,24 hDBP较A组降低,差异有统计学意义(P<0.05)。偏相关分析显示,24 hSBP、24 hPP、PPI与CysC呈正相关(偏相关系数分别为0.409、0.583、0.515,P<0.05),与eGFR呈负相关(偏相关系数分别为-0.264、-0.322、-0.249,P<0.05);24 hDBP与CysC、eGFR无相关(P>0.05)。多元逐步回归分析显示,24 hSBP、24 hPP、PPI与CysC独立相关(标准化偏回归系数分别为0.412、0.577、0.514,P<0.05)。进一步建立多元回归方程示,CysC每增加1 mg/L,24 hSBP、24 hPP、PPI相应增加17 mm Hg、16 mm Hg和0.06。结论原发性高血压病患者24 hSBP、24 hPP、PPI升高与CysC升高独立相关,24 hDBP与CysC水平无相关性。
Objective To investigate changes in blood levels of whether cystatin C, a marker of kidney function, in association with 24 h mean systolic BP （24 hSBP） , 24 h mean diastolic BP （24 h DBP） , 24 h mean pulse pressure （24 hPP） and pulse pressure index （PPI） during ambulatory blood pressure monitoring （ABPM） . Methods A total of 270 patients with essential hypertension without overt proteinuria were enrolled. A 24 h ABPM was performed, serum levels of cystatin C were measured, and estimated glomerular filtration rate （eGFR） was estimated using the abbreviated Modification of Diet in Renal Disease equation. The demographic, clinical and conventional analytical variables were documented. Subjects were stratified into two categories： PPI above and below the median （0. 437） . Partial correlation and multiple stepwise regression analyses were performed to confirm determine the relationship between ABPM＇ parameters and cystatin C. Results Subjects with a PPI above the median had worse values of renal function parameters （serum cystatin C, creatinine and eGFR） , had increased 24 hSBP and 24 hPP but decreased 24 hDBP, as compared with subjects with a PPI below the median. Partial correlations test showed that 24 hSBP, 24 hPP, and PPI were positively correlated with cystatin C （r = 0. 409, 0. 583 and 0. 515 respectively, P 〈 0. 05） but negatively correlated with eGFR （r = - 0. 264 , - 0. 322 and - 0. 249 respectively, P 〈 0. （5） . There was no close correlation between 24 hDBP and cystatin C, eGFR. The stepwise multiple linear regression analysis showed that 24 hSBP, 24 hPP, and PPI were each correlated independently with cystatin C （β = 0.412, 0.577, 0.514 respectively, P 〈 0. 05）; each 1 mg/L increase in cystatin C, 24 hSBP, 24 hPP and PPI would increase by 17 mm Hg , 16 mm Hg and o. 06 respectively. Conclusion Values of 24 hSBP ,24 hPP, and PPI are each independently correlated with cystatin C, whereas there is no significant correlation between 24 hDBP and cystatin C in patients with essential hypertension.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第1期43-46,共4页
Chinese General Practice
基金
云南省教育厅重点项目基金(2012Z091)
教育部高等学校博士学科专项研究基金(新教师类
20115317120003)
关键词
高血压
动态血压监测
动态血压均值
动态脉压
动态脉压指数
胱抑素C
Hypertension
Ambulatory blood pressure monitoring
24 h mean blood pressure
24 h mean pulse pressure
Pulse pressure index
Cystatin C
作者简介
通信作者：郭立，650101云南省昆明市，昆明医科大学第二附属医院；E—mall：guolidoe@163．com
