代谢综合征对老年高血压患者肾小球滤过率及颈动脉内膜中层厚度的影响

目的探讨代谢综合征对老年高血压患者。肾小球滤过率（GFR）及颈动脉内膜中层厚度（IMT）的影响。方法60例未经治疗的老年高血压患者均进行血压、腰围测量及血糖、血脂、肾功能检查，其中30例符合代谢综合征诊断标准（ATPⅢ标准）作为研究组，其余30例仅有高血压无代谢综合征者作为对照组。2组均进行颈动脉超声检查测定颈动脉IMT，根据简化的MDRD方程计算GFR，GFR〈60ml·min^-1·1．73m^-2诊断为慢性肾病。结果研究组与对照组GFR分别为（98．4±0．5）ml·min^-1·1.73m^-2和（119．1±11．9）ml·min^-1·73m^-2（P〈0．01）。2组中GFR〈60ml·min^-1·1．73m^-2的患者分别为26．7％与10．0％（P〈0．05），IMT分别为（0．62±0．18）mm和（0．58±0．22）mm（P〈0．05）。结论代谢综合征组GFR明显减低，慢性肾病增加，IMT明显增加。

The effect of metabolic syndrome on glomerular filtration rate and carotid artery intima-media thickness old hypertensive pa-tients

Objective To evaluate the effect of metabolic syndrome （MS） on glomerular filtration rate （GFR） and carotid artery intima-media thickness（IMT） in old hypertensive patients. Methods For a total of 60 old patients which hypertension were never previously treated ,blood pressure, waist circumference, fast glucose, high - density lipoprotein cholesterol, triglyceride, creatinine were detected. Carotid ultrasound also were carried out for measurement of carotid artery intima-media thickness in all 60 patients. Thirty eases met the standard of MS （ Adult Treatment Panel Ⅲ criteria） as study group, while the rest had no risk factors of MS as control group. GFR was calculated by using the abbreviated equation developed by the Modification of Diet in Renal Disease （MDRD）, and chronic kidney disease was defined as GFR 〈 60 ml · min ^-1 ·1.73 m^ -2. Results The GFR were （ 98. 4 ± 0. 5 ） ml · min ^-1 ·1.73 m^ -2 and （ 119. 1 ± 11 ）ml · min ^-1 ·1.73 m^ -2respectively in study group and control group （P 〈 0. 01 ）. The patients with GFR 〈 60 ml · min ^-1 ·1.73 m^ -2 were 26.7% and 10. 0% respectively in study group and control group （ P 〈 0. 05 ）. The IMT were （0. 62 ± 0. 18 ）mm and （0. 58 ± 0. 22 ） mm respectively in study group and control group （P 〈 0. 05）. Conclusions The GFR decreases obviausly, and IMT increases distinctly in old hypertensive patients with MS over no MS.