累积收缩压与估算的肾小球滤过率的关系

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目的探讨累积收缩压(cumSBP)与估算的肾小球滤过率(eGFR)的关系。方法在参加开滦集团2006-2007年度健康体检的职工101 510人中按抽样标准分层随机抽取观察对象,共抽取5852人,符合入选标准的为5440人,并于2012-2013年对该人群进行了第4次健康体检,并检测其肌酐水平,最终有4900名观察对象纳入统计分析。cumSBP=[(收缩压06+收缩压08)/2×time06-08]+[(收缩压08+收缩压10)/2×time08-10]+[(收缩压10+收缩压12)/2×time10-12],其中收缩压06、收缩压08、收缩压10、收缩压12分别为第1次、第2次、第3次、第4次体检所测血压,time06-08、time08-10、time10-12为相邻两次收缩压测量的时间间隔。采用多因素Logistic回归方法,分析cumSBP与eGFR的关系。结果年龄(54.6±11.4)岁的观察对象4900人中,男性2897人(59.1%),女性2003人(40.9%)。cumSBP六分位组eGFR水平差异有统计学意义(P<0.05),eGFR≤90mL/(min·1.73m2)的检出率随着cumSBP的增加而增加(P趋势<0.05)。在多因素Logistic回归分析中,校正其他混杂因素后,结果显示与cumSBP第1六分位组相比,第2、第3、第4、第5、第6六分位组发生eGFR≤90mL/(min·1.73m2)的风险增加,OR值(95%CI)分别为1.69(1.15~2.48)、1.85(1.28~2.67)、2.62(1.82~3.77)、3.12(2.15~4.52)、3.61(2.50~5.21)。结论 cumSBP增加是eGFR降低的危险因素。 Objective To investigate the relationship between cumulative systolic blood pressure (cumSBP) and estimated glomerular filtration rate (eGFR). Methods A total of 5852 workers were randomly selected from 101 510 workers who participated in the health check-up of Kailuan Group in 2006-2007 according to the sampling standard. A total of 5,852 people were selected, 5440 people met the inclusion criteria, The fourth physical examination took place and the creatinine level was measured. Finally, 4,900 subjects were included in the statistical analysis. cumSBP = [systolic pressure 06 + systolic pressure 08/2 × time06-08] + [systolic pressure 08 + systolic pressure 10/2 × time08-10] + [systolic pressure 10 + systolic pressure 12] / 2 × time10-12], including systolic blood pressure 06, systolic blood pressure 08, systolic blood pressure 10, systolic blood pressure 12 were the first, second, third, fourth physical examination of blood pressure, time06-08, time08- 10, time10-12 for the two adjacent systolic blood pressure measurement interval. The relationship between cumSBP and eGFR was analyzed by multivariate Logistic regression. Results Among 4,900 people who were 54.6 ± 11.4 years of age, 2897 were males (59.1%) and 2003 were females (40.9%). The eGFR level of cumSBP was significantly different (P <0.05). The detection rate of eGFR≤90mL / (min · 1.73m2) increased with the increase of cumSBP (P trend <0.05). In the multivariable Logistic regression analysis, after adjusting for other confounding factors, the results showed that eGFR≤90 mL / second in groups 2, 3, 4, 5 and 6 compared with cumSBP 1, (min · 1.73m2), the odds ratios (95% CI) were 1.69 (1.15-2.48), 1.85 (1.28-2.67), 2.62 (1.82-3.77), 3.12 (2.15-4.52), 3.61 ~ 5.21). Conclusion The increase of cumSBP is a risk factor for the decrease of eGFR.
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