| 老年难治性高血压患者动脉粥样硬化性肾动脉狭窄的发病状况及危险因素分析 |
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| 引用本文： | 李静,折剑青,王婧,刘美丽.老年难治性高血压患者动脉粥样硬化性肾动脉狭窄的发病状况及危险因素分析[J].中华全科医学,2022,20(9):1513-1516. |
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| 作者姓名： | 李静 折剑青 王婧 刘美丽 |
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| 作者单位： | 西安交通大学第一附属医院心血管内科，陕西 西安 710061 |
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| 基金项目： | 国家自然科学基金项目81800390 |
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| 摘 要： | 目的 调查老年难治性高血压患者动脉粥样硬化性肾动脉狭窄(ARAS)的发病状况，并分析其危险因素，为临床早期诊治ARAS提供依据。 方法 回顾性分析2016年2月—2021年2月在西安交通大学第一附属医院心内科门诊就诊的老年难治性高血压患者216例的临床资料，根据肾动脉彩超和造影结果分为ARAS组(48例)和非ARAS组(168例)。比较2组临床资料，并分析患者发生ARAS的危险因素。 结果 216例患者肾动脉超声提示ARAS共62例(28.70%)，经肾动脉造影结果确诊ARAS共48例(22.22%)。ARAS组合并糖尿病、高脂血症、外周血管疾病、冠心病、肾功能不全比例分别为47.92%(23/48)、68.75%(33/48)、39.58%(19/48)、54.17%(26/48)、52.08%(25/48)，明显高于非ARAS组30.36%(51/168)、51.19%(86/168)、18.45%(31/168)、34.52%(58/168)、26.79%(45/168)，均P＜0.05]；多因素logistic回归分析显示，合并外周血管疾病(OR=2.651, 95% CI:1.039~6.764)、肾功能不全(OR=2.713, 95% CI:1.106~6.656)是老年难治性高血压患者发生ARAS的独立危险因素。 结论 老年难治性高血压患者ARAS的发生率较高，合并外周血管疾病、肾功能不全是患者发生ARAS的独立危险因素。
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| 关 键 词： | 老年难治性高血压 动脉粥样硬化 肾动脉狭窄 危险因素 |
| 收稿时间： | 2022-01-22 |
Incidence and risk factors of atherosclerotic renal artery stenosis in elderly patients with refractory hypertension |
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| Affiliation: | Department of Cardiology, the First Affiliated Hospital of Xi ' an Jiaotong University, Xi ' an, Shaanxi 710061, China |
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| Abstract: | Objective To investigate the incidence of atherosclerotic renal artery stenosis (ARAS) in elderly patients with refractory hypertension and to analyse its risk factors, to provide evidence for the early clinical diagnosis and treatment of ARAS. Methods The clinical data of 216 elderly patients with refractory hypertension treated in the Cardiology Department of the First Affiliated Hospital of Xi ' an Jiaotong University from February 2016 to February 2021 were retrospectively analysed. According to the results of renal artery color Doppler ultrasonography and angiography, they were divided into ARAS (n=48) and non-ARAS (n=168) groups. The clinical data of the two groups were compared, and the risk factors for ARAS were analysed. Results In 216 patients, 62 cases (28.70%) were diagnosed as ARAS by renal arterial ultrasonography, and 48 cases (22.22%) were confirmed as ARAS by renal arteriography. The proportions of diabetes mellitus, hyperlipidemia, peripheral vascular disease, coronary heart disease, renal insufficiency in the ARAS group were 47.92% (23/48), 68.75% (33/48), 39.58% (19/48), 54.17% (26/48) and 52.08% (25/48), respectively, significantly higher than those in the non-ASAR group 30.36% (51/168), 51.19% (86/168), 18.45% (31/168), 34.52% (58/168) and 26.79% (45/168), respectively, all P < 0.05]. Multivariate logistic-regression analysis showed that peripheral vascular disease (OR=2.651, 95% CI: 1.039-6.764) and renal insufficiency (OR=2.713, 95% CI: 1.106-6.656) were independent risk factors for ARAS in elderly patients with refractory hypertension. Conclusion Elderly patients with refractory hypertension have a higher incidence of ARAS, and peripheral vascular disease and renal insufficiency are independent risk factors affecting ARAS occurrence. |
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