本文關(guān)鍵詞：H型高血壓患者同型半胱氨酸對(duì)腎臟功能的影響　出處：《新疆醫(yī)科大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

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【摘要】：目的：探討H型高血壓患者的同型半胱氨酸水平對(duì)腎臟功能的影響。方法：選取2012-2014年在新疆醫(yī)科大學(xué)第一附屬醫(yī)院高血壓科確診的原發(fā)性高血壓患者853例,其中H型高血壓患者412例,單純高血壓患者441例,收集患者一般臨床資料、24小時(shí)動(dòng)態(tài)血壓、生化指標(biāo)、24小時(shí)尿蛋白定量、24小時(shí)尿微量白蛋白、同型半胱氨酸水平等,分析H型高血壓患者同型半胱氨酸水平對(duì)腎臟功能的影響。結(jié)果：(1)H型高血壓組與單純高血壓組的性別構(gòu)成比、空腹血糖(FBG)、膽固醇(TC)、低密度脂蛋白-膽固醇(LDL-C)、糖化血紅蛋白(HbAlC)、24小時(shí)平均收縮壓(24hSBP)、24小時(shí)平均舒張壓(24hDBP)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；H型高血壓組年齡、高血壓病程、高密度脂蛋白-膽固醇(HDL-C)、同型半胱氨酸水平比單純高血壓組高；而甘油三脂(TG)低于單純高血壓組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)H型高血壓組與單純高血壓組尿酸、尿素、肌酐、24小時(shí)尿蛋白定量差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；H型高血壓組胱抑素C、24小時(shí)尿微量白蛋白高于單純高血壓組,而eGFR低于單純高血壓組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)多因素logistic回歸分析顯示：高血壓病程(OR=7.518,95%CI 1.153-2.349)、年齡(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的危險(xiǎn)因素；血壓未達(dá)標(biāo)(OR=10.026,95%CI 1.283-2.887)是24小時(shí)尿微量白蛋白的危險(xiǎn)因素；男性(OR=7.842,95%CI1.207-2.907)、年齡(OR=14.054,95%CI 1.578-4.289)、同型半胱氨酸(OR=0.221,95%CI 1.227-2.92)為eGFR的危險(xiǎn)因素。結(jié)論：高血壓病程、年齡、男性、同型半胱氨酸是胱抑素C的危險(xiǎn)因素；血壓未達(dá)標(biāo)是24小時(shí)尿微量白蛋白的危險(xiǎn)因素；男性、年齡、同型半胱氨酸是eGFR的危險(xiǎn)因素。同型半胱氨酸是H型高血壓患者早期腎臟功能損害的危險(xiǎn)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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R544.14
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本文編號(hào)：1376130