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论著:肾小球疾病患者高血压患病率的影响因素分析
Prevalence and Risk Factors of Hypertension in Renal Glomerular Disease Patients
傅淑霞 邢玲玲 段建召 张春霞 闫喆 张丽萍 张晓琳
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作者单位:河北医科大学第二医院肾内科
中文关键字:肾小球疾病;慢性肾脏病;高血压
英文关键字:Renal glomerular disease; Chronic kidney disease; Hypertention
中文摘要:目的:探讨肾小球疾病患者合并高血压的发生率及其影响因素。方法:回顾分析3 003例肾活检和临床确诊的肾小球疾病患者的临床、病理及实验室检查资料。结果:(1)高血压患病率为48.6%(中度和重度高血压占36.5%),其中不同肾病理类型患者高血压患病率糖尿病肾病(DN)最高(84.3%),微小病变肾病(MCD)最低(26.7%);不同职业患者高血压患病率农民最高(56.7%),学生最低(16.8%)。高血压知晓率为49.1%,控制率(血压<140/90 mmHg)为19.4%;(2)伴高血压者的血钠和心电图异常发生率明显升高;(3)高尿酸血症、高血压家族史、超重或肥胖、空腹血糖水平、慢性肾病(CKD)分期、病程、年龄、肾小球硬化、肾内血管病变及间质小管病变均影响高血压的发生。结论:半数肾小球疾病患者伴高血压,但高血压知晓率和控制率均低。高尿酸血症、高血压家族史、超重或肥胖、糖代谢异常、病程长、增龄、肾功能差及肾组织慢性病变程度重均是发生高血压的独立危险因素。
英文摘要:Objective: To evaluate the prevalence and the risk factors of hypertension in renal glomerular disease patients verifacated by renal biopsy. Methods: The clinical and pathological data were collectded and analyzed for 3003 patients with renal glomerular disease. Results: (1)The prevalence of hypertension was 48.6%,in which the ratio of modolate and severe hypertension was 36.5%; the highest rate of hypertension was in diabetic nephropathy (84.3%), the lowest in minimal change disease (26.7%); the highest rate was in the farmers (56.7%), the lowest was in the students. There were 49.1% of participants with hypertension who were aware of this diagnosis, whereas 19.4% had hypertension controlled to <140/90mmHg. (2)The abnormal ratio of both blood sodium and electrocardiogram were higher in hypertension patients than that in non-hypertention patients. (3)A multivariate logistic regression analysis showed that hyperuricemia, hypertensive family history ,overweight or obesity,fasting blood sugar,the stage of chronic kidney disease, course of disease,age, intrarenal vessel lesion, glomerulosclerosis and interstitial tubular lesion had effect on hypertension. Conclusions: Almost a half of renal glomerular disease patients have accompanied with hypertension, but the awareness rate and the control rate of hypertension are low. Hyperuricemia, hypertensive family history, overweight or obesity, abnomal glycometabolism,long course of disease, old age, bad renal function and chronic severe pathological changes of renal tissue are independent risk factors, leading to hypertention.
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