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雷永富1,李敏2
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雷永富1 ,李敏2 . 住院老年高血压患者的血糖改变及其对肾功能的影响[J]. .
摘要: 临床上,不少老年高血压患者尿常规检查尿蛋白为阴性,而患者出现不同程度的肾功能损害,这类问题国内外文献报道不多。本文旨在探讨老年高血压住院患者中尿蛋白阴性患者的血糖改变及其对肾功能的影响。
关键词: 高血压, 血糖, 肾功能, 老年人
Abstract: Abstract Objective:To investigate Change of Blood Sugar in Hospital elderly patients with hypertension and it’s influence on state of renal function . Methods:Chose elderly patients with hypertension hospitalized for research object, their some index were measured such as BMI, blood lipids, serum creatinine, OGTT,IRT and arterial blood pressure after admission, GADAb were measured in patients with diabetes mellitus. The next day after admission, 2 hours urine was collected to test urine albumin and creatinine concentration and calculation UAER, eGFR was calculated according to Cookroft - Gaut formula; in the First place , all of the patients was grouped on the basis of Whether UAER≥3.5 mg/ mmol to Compare the absolute value of the patients’ eGFR between the two groups patients with the same Blood Sugar state, the proportion of patients with eGFR significantly decrease, and the eGRF absolute value in patients with different blood sugar levels in the same UAER group, The next grouping criteria was whether eGFR acuities 60ml/min. 1.73m2 ,comparing the change of some index including age, sex, BMI, blood pressure and Blood Sugar levels between the two groups. Results:(1)The incidence of abnormal glucose metabolism was 80.70%.(2)There is a higher incidence of renal impairment, showing abnormal UAER and obvious renal insufficiency (53.91% vs21.39% ,respectively) (3)Compared with normal UAER group, there were lower absolute value of eGFR in UAER abnormal group patient regardless of how their blood glucose levels, and the proportion of the obvious decline of renal function was significantly higher. In UAER abnormal group, the levels of eGFR have a statistically difference among patients with different blood glucose levels, eGFR in T2DM group was the lowest in three group. (4) With eGFR> 60 ml / min .1.73 m2 group comparison: age and blood pressure were higher, more common women , with blood glucose levels elevated ,percentage of the obvious decline of renal function increasing in eGFR ≤ 60ml / min .1.73 m2 group, this percentage was the highest in T2DM group . Conclusion:(1) Abnormal glucose metabolism were very common in elderly patients with hypertension hospitalized.(2) The incidence of kidney damage were higher, performance for UAER abnormal or eGFR reduce or both cocurrence. (3) Renal impairment occurrence involves glucose metabolic disorder, elevated blood pressure and the growth of the age.
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https://www.tjyybjb.ac.cn/CN/Y2011/V39/I12/1158