老年原发性高血压患者踝臂指数分析

目的探讨老年原发性高血压患者左心室肥厚(LVH)与估算的肾小球滤过率(eGFR)及踝臂指数(ABI)的关系。方法选择215例老年原发性高血压患者,根据ABI<0.9定义为外周动脉疾病(PAD),并分为PAD组51例和非PAD组1 64例,2组均做超声心动图检查、测血肌酐、ABI、血脂、糖化血红蛋白(HbAlc)和血压等,并收集相关影响因素,根据肌酐计算eGFR。分析LVH与eGFR及ABI的关系。结果与非PAD组比较,PAD组收缩压明显增高,eGFR明显减少(P<0.05);收缩压是ABI的独立危险因素(OR=1.023,95%CI:1.001～1.046,P<0.05)。左心室重量指数与eGFR、LDL-C呈负相关(r=-0.237、P<0.01,r=-0.157、P<0.05)。eGFR(OR=-3.016,95%CI:-0.428～-0.090,P<0.01)、LDLC和收缩压为LVH的危险因素,ABI降低对LVH无明显影响。结论老年原发性高血压患者伴PAD时,血压升高、eGFR下降,eGFR与LVH有关,可能是LVH的危险因素之一,LVH时大动脉硬化较无高血压患者严重。

Analysis of the ankle-brachial index in elderly patients with essential hypertension

Objective To investigate the relationship of left ventricular hypertrophy(LVH) in elderly hypertensive(EH) patients with estimated Glomerular Filtration Rate(eGFR)and Ankle-Brachial Index(ABI).Methods A total of 215 elderly EH patients were included in this study.ABK 0.9 is defined as peripheral arterial disease(PAD),includeing 51 patients of PAD and 164 without PAD,for whom ultrasonic cardiogram,serum creatinine(Cr),ABI,lipids profile,hemoglobin Alc and blood pressure were examined.Cardiovascular risk factors and cardiovascular diseases(CVD) were collected.eGFR was calculated based on Cr analysis of the reltionship of LVH with eGFR and ABI.Results Compared to patients without PAD,the levels of SBP were significantly increased, and the level of eGFR was significantly decreased in patients with PAD(P<0.05).SBP is Independent risk factor of ABI(OR=l.023,95%CI:1.001 - 1.046,P<0.05),LVMI showed a negative correlation with eGFR,LDL-C(r = - 0.237,P<0.01;r=- 0.157,P< 0.05).Logistic regression analysis showed that eGFR(OR= - 3.016,95%CI:-0.428～-0.090,P<0.01) and LDL-C,SBP are risk factors for LVH,and there was no association between ABI reduction and LVH.Conclusion The levels of SBP increased and the level of eGFR significantly decreased in patients with PAD in the elderly EH population.eGFR is associated with LVH,and could be a risk factor for LVH.Atherosclerosis is more serious in LVH patients.