天津医药

• 论著 • 上一篇    下一篇

老年高血压患者左室肥厚及估算肾小球滤过率5年随访

李敏1,雷永富2   

  1. 1. 湖北省潜江市：江汉油田总医院（五七）
    2. 湖北江汉油田总医院（五七）
  • 收稿日期:2011-06-28 修回日期:2011-10-10 出版日期:2012-05-15 发布日期:2012-05-15
  • 通讯作者: 雷永富

LVH and eGFR five-year follow-up in older hypertensive patients

  • Received:2011-06-28 Revised:2011-10-10 Published:2012-05-15 Online:2012-05-15

PDF (PC)

2280

摘要： 目的 研究老年高血压病人治疗过程中LVH及eGFR的改变。方法 选择在本科住院病史资料完整并随访五年及以上的老年高血压病人为研究对象，自2004.1.1起凡在本科住院的老年高血压病人入院后均测血压、体重指数，血糖、血脂、血肌酐、血尿酸、糖化血红蛋白、尿白蛋白/肌酐比值，肾小球滤过率，心电图及心脏彩超。依尿白蛋白/肌酐比值，肾小球滤过率为指标将病人分为慢性肾脏病组（CKD组）及非慢性肾脏病组（NCKD组）。住院期间均选择以坎地沙坦为主的降压治疗措施，长期坚持上述方案治疗使病情控制达标，定期复查并随访五年以上；两组病人同一时间点相关指标及同组内同一指标按不同随访时间进行比较。结果 1、两组间比较，各相同时间点对应的收缩压及舒张压的差异无统计学意义，而LVMI、LVH及eGFR比较,差异有统计学意义。2、同组内与基线水平比较，CKD组各时间点的收缩压、舒张压、LVMI、LVH及eGFR均显著改善，差异有统计学意义，但在随后的4年中，上述各指标的变化无统计学意义。在5年的随访中，NCKD组eGFR的变化无统计学意义。结论 1、老年高血压病人中CKD及LVH的发生率较高。2、随着血压控制达标，LVH被逆转并伴有CKD患者肾小球滤过率的改善。eGFR呈良性经过。

关键词: 高血压, 左室肥厚, 肾小球滤过率, 慢性肾脏病

Abstract: Objective To study change of LVH and eGFR in the process of therapy in the elderly patient with hypertension. Methods object of study were the elderly patients with hypertension hospitalized and the period of follow-up was five years or more than five years with comprehensive information including blood pressure, BMI, blood sugar, blood fat, blood creatinine, uric acid, urinary albumin/creatinine ratio, glomerular filtration rate, electrocardiogram and echocardiography . all patients would be divided into CKD group and NCKD group according to ACR and eGFR index. Candesartan was chosen mainly antihypertensive treatment measures to achieve the goal blood pressure during their hospitalization and the scheme was sustained during outpatient service.they were followed-up regularly.indexes related were compared at the same time points between groups, the same index were compared according to different followed-up time in the same group. Results (1) Compared between two groups, there were not statistically difference of corresponding systolic blood pressure and diastolic blood pressure, while there were statistically significance concerning difference of LVMI, LVH and eGFR at the same time point,(2) in comparison with the baseline state , except eGFR in NCKD group ,each index at various time point were improved with statistically significance ,including the systolic blood pressure, diastolic blood pressure, LVMI, LVH and eGFR, but the change with statistically significance did not appear among these indexes in the course of subsequent followed-up 4 years, there were not statistically difference concerning eGFR change in NCKD group in followed-up period of 5 years. Conclusion (1) The incidence of CKD and LVH were higher in the elderly hypertensive patients. (2) with blood pressure successful control, the LVH of patients was improved with glomerular filtration rate taken a turn for the better in CKD patients. The eGFR of patients with hypertension was a benign transformation process.