老年糖尿病血清胱抑素C水平与高血压相关性研究

发布时间：2018-03-23 01:01

本文选题：老年患者　切入点：糖尿病　出处：《第三军医大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的研究糖尿病老年患者血清胱抑素C水平与高血压发病的相关性,探讨血清胱抑素C水平与老年糖尿病合并高血压发病的关系。方法收集2013年1月~2014年8月期间资料完整的在第三军医大学附属第一医院(西南医院)老年科住院患者538例,依据患者是否患有高血压分为高血压组(347例)、非高血压组(191例)两组。收集所选患者的基本临床资料,其中包括性别、年龄、身体质量指数(BMI)、血压、血脂、血肌酐、血清胱抑素C、N末端B型利钠肽原(NT-ProBNP)、高敏C反应蛋白(hs-CRP)、空腹血糖和糖化血红蛋白。统计分析应用SPSS 19.0统计软件进行。其中计量资料用±s表示,进行正态性、方差齐性检验,其中各组间方差齐性且符合正态性分布的计量资料,采用单因素方差分析;而不符合正态分布的计量资料,采用Mann-Whitney非参数检验。计数资料采用检验。结果2组间性别比例、血脂情况、血肌酐、血清胱抑素C、NT-ProBNP、hs-CRP、空腹血糖水平和糖化血红蛋白无显著差异。依据高血压分级,将高血压患者分成3个组,即高血压1级组、高血压2级组和高血压3级组。与对照组比较,高血压3级组的患者在年龄、BMI指数、收缩压、舒张压、血清胱抑素C、NT-ProBNP、hs-CRP水平上均明显增高,差别有统计学差异(p0.05)。同样与对照组(非高血压组)比较,高血压1级组和高血压2级组患者的收缩压、舒张压水平呈现明显增高(p0.05);而与高血压1级组患者比较,高血压3级组患者血清胱抑素C水平呈显著增高(p0.05)。运用Spearman相关分析提示,患者年龄、吸烟情况、BMI指数、肌酐、血清胱抑素C、NT-ProBNP与高血压具有相关性。运用多元logistic回归分析提示患者年龄、吸烟情况、BMI指数和血清胱抑素C与高血压发病具有相关性。再设置血清胱抑素C水平为因变量,运用Spearman相关分析统计各个危险因数与血清胱抑素C水平相关性,结果提示各种危险因素当中,与糖尿病老年患者血浆血清胱抑素C水平具有相关性的有患者年龄、性别、吸烟情况、收缩压、TC、LDL-c、HDL-c、肌酐水平、NT-proBNP以及hs-CRP。结论伴随糖尿病老年患者血清胱抑素C水平的上升,高血压的发生率有增高趋势,揭示血清胱抑素C有可能是老年糖尿病患者合并高血压的独立危险因素。血清胱抑素C的升高与高脂、炎症状态有关,提示血清胱抑素C可能共同参与血管粥样硬化等病变及发病。
[Abstract]:Objective to study the correlation between serum cystatin C level in elderly patients with diabetes and hypertension, to explore the relationship between serum cystatin C level and elderly diabetic patients with hypertension. Methods from January 2013 August ~2014 data in the First Affiliated Hospital of Third Military Medical University (Southwest Hospital) in 538 cases of hospitalized elderly families, according to whether patients with hypertension were divided into hypertension group (347) and non hypertension group (191 cases) in two groups. The collection of basic clinical data were selected, including gender, age, body mass index (BMI), blood pressure, blood lipid, serum creatinine, serum cystatin C, N terminal B type natriuretic peptide (NT-ProBNP), high sensitive C reactive protein (hs-CRP), fasting blood glucose and glycosylated hemoglobin. Statistical analysis was performed using SPSS 19 statistical software. The measurement data is represented by + s, normality, homogeneity of variance test, which were square The difference is homogeneous and in accordance with the measurement data of normal distribution, using the single factor analysis of variance; and does not conform to the normal distribution of the measurement data, using the Mann-Whitney non parametric test. Test with count data. Results among the 2 groups of sex ratio, blood lipid, serum creatinine, serum cystatin C, NT-ProBNP, hs-CRP, no significant difference fasting blood glucose levels and glycosylated hemoglobin. According to the grade of hypertension, hypertensive patients were divided into 3 groups: Grade 1 hypertension group, hypertension group and grade 2 grade 3 hypertension group. Compared with the control group, the patients with grade 3 hypertension group in age, BMI index, systolic blood pressure, diastolic blood pressure, serum cystatin C, NT-ProBNP. The level of hs-CRP increased significantly, the difference was statistically significant (P0.05). The same with the control group (non hypertension group), grade 1 hypertension group and hypertension grade 2 group of patients with systolic blood pressure, diastolic blood pressure levels showed significantly increased (P0.05); and high blood Pressure level 1 group of patients, grade 3 hypertension patients serum cystatin C levels were significantly higher (P0.05). Using the Spearman correlation analysis showed that age, smoking status, BMI index, serum creatinine, serum cystatin C, NT-ProBNP were associated with hypertension. Multivariate logistic regression analysis showed that age, smoking index, BMI and serum cystatin C and the incidence of hypertension is associated. And then set the level of serum cystatin C as the dependent variable, using the correlation Spearman correlation analysis statistics of each risk factor and the level of serum cystatin C, the results suggest a variety of risk factors, and the correlation between plasma levels of serum cystatin C in elderly patients with diabetes mellitus have included age, gender, smoking status. The systolic blood pressure, TC, LDL-c, HDL-c, NT-proBNP and creatinine levels, hs-CRP. increased with the conclusion in diabetic patients aged clear levels of cystatin C, high blood The trend rate of increase pressure, revealing the serum cystatin C may be independent risk factors for elderly patients with diabetes mellitus complicated with hypertension. With the increase of hyperlipidemic serum cystatin C, inflammatory status, serum cystatin C may be involved in atherosclerosis and other diseases and disease.

【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1;R587.1

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