【摘要】 目的研究住院患者难治性高血压(RH)的独立危险因素。方法回顾2004-01-2008-12住院原发性高血压患者病例资料2362例,其中RH505例,非RH1857例。收集患者的性别、年龄、体质量指数(BMI)、血脂、血糖、血压、估算的肾小球滤过率(eGFR)、左室质量指数以及是否患有糖尿病等资料。通过单因素及多因素logistic回归分析RH的独立危险因素,以及RH左心室肥厚(LVH)与eGFR下降[eGFR<90mL/(min.1.73m2)]的独立危险因素。结果以RH和非RH为因变量进行分析,结果显示糖尿病、BMI、总胆固醇与RH独立相关;24h平均动脉压(24hMAP)和24h脉压升高与RH患者的LVH的独立相关;男性、年龄、24h脉压升高与eGFR下降独立相关。结论糖尿病、BMI、总胆固醇是RH的独立危险因素;男性、年龄、24hMAP、24h脉压升高是RH患者靶器官受损的独立危险因素。更多还原

【Abstract】 Objective To evaluate the independent risk factor of resistant hypertension (RH). Methods Twenty-three hundreds and sixty-two essential hypertensive inpatients were recruited from the division of hypertension of Ruijin hospital affiliated to Shanghai Jiaotong university from Jan. 2004 to Dec. 2008,among which 505 were RH,1857 were non-RH. The demographic and clinical data of patients were collected,including gender,age,body mass index (BMI),serum lipid level,fasting blood glucose,blood pressure,estimated glomerular filtration rate (eGFR),left ventricular mass index (LVMI) and diabetes history. The univariate and multivariate logistic regression were performed to estimate the risk factor of RH,and to assess the independent risk factors of LVH and decreased eGFR [eGFR<90 mL/(min·1.73 m2)] in patients with RH. Results RH was associated with diabetes,BMI and TC. The risk factors for left ventricular hypertrophy (LVH) include 24 h mean artery pressure (24 h MAP) and 24 h mean pulse pressure (24 h PP). The risk factors for renal impairment include male,age and high 24 h PP. Conclusion Diabetes,BMI and TC were independent risk factors of RH,and male,age,24 h MAP and high 24 h PP were independent risk factors for RH with the target organ damage.更多还原