【摘要】 目的:观察高血压人群中顽固性高血压(RH)患者合并慢性肾脏疾病(CKD)的患病率及CKD发生与心血管病危险因素之间的关系。方法:入选2008年10月至2009年10月安贞医院高血压科的高血压患者,通过MDRD公式估算肾小球滤过率(eGFR),评估肾功能,进行24h动态血压监测和睡眠呼吸暂停监测。结果:215例患者,年龄20～84岁。其中RH组患者120例,非RH患者95例,CKD的发病率RH组为31.67%(38/120),非RH为10.53%(10/95),P=0.002。全部RH患者发生CKD的独立相关危险因素有高血压病程(OR=1.33,P<0.05)、高尿酸血症(OR=1.026,P<0.05)和合并睡眠呼吸暂停综合征(OSA)(OR=50.2,P<0.05)。男性RH发生CKD独立相关危险因素为有高尿酸血症(OR=1.001,P<0.05)与合并OSA(OR=4.601,P<0.05);女性RH发生CKD独立相关危险因素有高血压病程(OR值1.133)。结论:顽固性高血压肾功能损害明显加重,当GFR<60(mL.min-1.1.73m-2)时,高血压病程、高尿酸血症和合并OSA是其发生的独立危险因素。更多还原

【Abstract】 Objective:To study the prevalence of chronic kidney disease(CKD) and the relationship between CKD and cardiovascular risk factor construction in Resistant Hypertension(RH).Methods:215 hypertensive patients from Department of Hypertensionology in Anzhen hospital were divided into two groups(120 patients of RH group and 95 patiens of NRH group),assessing renal function,monitoring 24h ambulatory blood pressure and measuring obstructive sleep apnea.Results:In RH group the incidence of was 31.67%(38/120)higher than that of NRH [10.53%(10/95),P=0.002].The independent risk factor of CKD in all RH were hypertensive yesrs(OR rate 1.33),hyperuricemia(OR rate 1.026),and complicating OSAS(OR rate 1.33).In male RH,the independent risk factors of CKD were hyperuricemia(OR rate 1.0001) and complicating OSAS(OR rate 4.601).In female RH,the independent risk factors of CKD was hypertensive yesrs(OR rate 1.133).Conclusion:Renal function degression were more serious in RH than that of NRH.Hypertensive yesrs,hyperuricemia and complicting OSAS were independent risk factor for CKD in RH patients.更多还原