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目的:探讨长时和短时收缩压变异性指标与老年人群肾脏损害的关联。方法:在参加开滦研究队列第三次健康体检的人群中,采取整群抽样的方法按照25%比例随机抽取年龄≥60岁的开滦集团离退休员工进行24小时动态血压监测等检查。在随机抽取的3 064例观察对象中,符合入选标准的为2 464例。收缩压变异性(SBPV)采用标准差(SSD)、独立变异性(VIM)、极差(MMD)和平均真实变异性(ARV)四种指标;肾脏损害采用肾小球滤过率(eGFR)、尿微量白蛋白(ALBU)两种指标。采用逐步线性回归方法,分析不同长时和短时SBPV指标与eGFR、ALBU的关联。结果:(1)在2 464例观察对象中,年龄平均为(67.41±6.05)岁。其中,男性1 667例(67.7%),女性797例(32.3%)。(2)在逐步线性回归分析中,不同长时SBPV指标均与eGFR、ALBU无线性相关;四项24h SBPV指标、三项日间SBPV指标(SSD、MMD、ARV)均与eGFR呈负线性相关,24 h ARV、日间MMD、日间ARV均与ALBU呈正线性相关,夜间SBPV指标均与eGFR、ALBU无线性相关。结论:不同短时收缩压变异性指标与eGFR、ALBU均存在一定程度的关联。
Objective: To investigate the relationship between long-term and short-term systolic pressure variability and renal damage in the elderly. Methods: Among the crowd who participated in the third health check-up of Kailuan Research Cohort, we adopted the method of cluster sampling to randomly select 24-hour ambulatory blood pressure monitoring for retired employees of Kailuan Group who were over 60 years old according to the proportion of 25%. Of the 3,064 randomized participants, 2 464 met the inclusion criteria. Systolic pressure variability (SBPV) using four indicators of standard deviation (SSD), independent variability (VIM), very poor (MMD) and average true variability (ARV); renal damage using glomerular filtration rate (eGFR) , Urine microalbumin (ALBU) two indicators. The stepwise linear regression method was used to analyze the association of different long-term and short-term SBPV indexes with eGFR and ALBU. Results: (1) Among 2 464 observation subjects, the average age was (67.41 ± 6.05) years old. Among them, there were 1 667 males (67.7%) and 797 females (32.3%). (2) In the stepwise linear regression analysis, different long-term SBPV indexes were linearly correlated with eGFR and ALBU. Four 24h SBPV indexes and three daytime SBPV indexes (SSD, MMD and ARV) were negatively correlated with eGFR 24 h ARV, daytime MMD and daytime ARV were all positively correlated with ALBU. Nighttime SBPV was associated with eGFR and ALBU. Conclusion: There are some correlations between echocardiography and eGFR and ALBU at different short-term systolic pressure variability indexes.