H型高血压患者同型半胱氨酸对肾脏功能的影响

发布时间：2018-01-03 23:35

  本文关键词：H型高血压患者同型半胱氨酸对肾脏功能的影响　出处：《新疆医科大学》2015年硕士论文　论文类型：学位论文

  更多相关文章： H型高血压 同型半胱氨酸 肾脏功能

【摘要】：目的：探讨H型高血压患者的同型半胱氨酸水平对肾脏功能的影响。方法：选取2012-2014年在新疆医科大学第一附属医院高血压科确诊的原发性高血压患者853例,其中H型高血压患者412例,单纯高血压患者441例,收集患者一般临床资料、24小时动态血压、生化指标、24小时尿蛋白定量、24小时尿微量白蛋白、同型半胱氨酸水平等,分析H型高血压患者同型半胱氨酸水平对肾脏功能的影响。结果：(1)H型高血压组与单纯高血压组的性别构成比、空腹血糖(FBG)、胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、糖化血红蛋白(HbAlC)、24小时平均收缩压(24hSBP)、24小时平均舒张压(24hDBP)差异无统计学意义(P0.05)；H型高血压组年龄、高血压病程、高密度脂蛋白-胆固醇(HDL-C)、同型半胱氨酸水平比单纯高血压组高；而甘油三脂(TG)低于单纯高血压组,差异有统计学意义(P0.05)。(2)H型高血压组与单纯高血压组尿酸、尿素、肌酐、24小时尿蛋白定量差异无统计学意义(P0.05)；H型高血压组胱抑素C、24小时尿微量白蛋白高于单纯高血压组,而eGFR低于单纯高血压组,差异有统计学意义(P0.05)。(3)多因素logistic回归分析显示：高血压病程(OR=7.518,95%CI 1.153-2.349)、年龄(OR=41.234,95%CI 2.150-4.214)、男性(OR=8.54,95%CI 1.168-2.202)、同型半胱氨酸(OR=16.207,95%CI 1.382-2.553)是胱抑素C的危险因素；血压未达标(OR=10.026,95%CI 1.283-2.887)是24小时尿微量白蛋白的危险因素；男性(OR=7.842,95%CI1.207-2.907)、年龄(OR=14.054,95%CI 1.578-4.289)、同型半胱氨酸(OR=0.221,95%CI 1.227-2.92)为eGFR的危险因素。结论：高血压病程、年龄、男性、同型半胱氨酸是胱抑素C的危险因素；血压未达标是24小时尿微量白蛋白的危险因素；男性、年龄、同型半胱氨酸是eGFR的危险因素。同型半胱氨酸是H型高血压患者早期肾脏功能损害的危险因素。
[Abstract]:Objective: to investigate the effect of homocysteine level on renal function in patients with H type hypertension. 853 patients with essential hypertension diagnosed in the Department of Hypertension of the first affiliated Hospital of Xinjiang Medical University from 2012 to 2014 were selected. There were 412 patients with H type hypertension and 441 patients with simple hypertension. The general clinical data of patients were collected and 24 hours ambulatory blood pressure was collected. 24 hours urinary microalbumin, homocysteine level, etc. The effect of homocysteine level on renal function in patients with type H hypertension was analyzed. Low density lipoprotein cholesterol (LDL-C), HbAlC (24 h SBP). There was no significant difference in DBP between 24 hours and 24 hours (P 0.05). Age, course of hypertension, HDL-CU and homocysteine levels in H type hypertension group were higher than those in simple hypertension group. However, TGs of triglyceride group were lower than that of simple hypertension group, the difference was statistically significant (P 0.05). There was significant difference between hypertension group and simple hypertension group in uric acid, urea, creatinine. There was no significant difference in 24 hour urine protein (P 0.05). In H type hypertension group, the concentration of cystatin Con in 24 hours urine microalbumin was higher than that in simple hypertension group, but the eGFR was lower than that in simple hypertension group. The multivariate logistic regression analysis showed that the course of hypertension was 7.518. 95 CI 1.153-2.349, age 41.23495 CI 2.150-4.214. 95 CI 1.168-2.202, homocysteine OR16.207 and CI 1.382-2.553 are risk factors for cystatin C. The risk factor of 24 hours urinary microalbumin was CI 1.283-2.887. The male was 7.84295, CI1.207-2.907, and the age was 14.054 / 95CI 1.578-4.289). Homocysteine ORO 0.221 95 CI 1.227-2.92) is the risk factor of eGFR. Conclusion: hypertension course, age, male. Homocysteine is a risk factor for cystatin C. The risk factor of 24 hours urinary microalbumin was that blood pressure was not up to standard. Male, age, and homocysteine are risk factors for eGFR. Homocysteine is a risk factor for early renal dysfunction in patients with type H hypertension.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.14
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