高血压肾损害危险因素和炎性因子的临床分析

来春林; 邢金平; 刘晓红; 齐杰; 赵建强; 冀友瑞; 杨五晓; 燕蒲娟; 罗春艳; 阮露芳

doi:10.13201/j.issn.1001-1439.2017.08.007

高血压肾损害危险因素和炎性因子的临床分析

- 山西省人民医院心内科(太原, 030012)
基金项目:
山西省社会发展基金 (No:20120313018-8)

详细信息

通讯作者: 来春林,E-mail:Lai0817@hotmail.com

中图分类号: R544.1

收稿日期: 2017-03-01

Analysis of the related clinical factors and inflammatory factors in patient of essential hypertension with chronic kidney damage

- Department of Cardiology, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, 030012, China

More Information

Corresponding author: LAI Chunlin, E-mail: Lai0817@hotmail.com

Received Date: 01 March 2017

摘要

摘要: 目的:探讨原发性高血压(essential hypertension, EH)患者血清炎性因子和临床相关生化指标及高危因素在慢性肾损害(chronic kidney damage, CKD)中的作用,分析其与EH患者发生CKD的关系。方法:选取符合纳入标准的EH患者127例,按照靶器官损伤(target organ damage, TOD)标准分为单纯EH组79例,EH合并CKD组48例。测定每组患者临床相关的生化指标和血管特异性炎性因子脂蛋白相关磷脂酶A2(lipoprotein associated phospholipase A2, LP-PLA2)水平,统计每组患者的相关危险因素,采用多因素logistic回归分析EH患者发生CKD的各因素及其临床意义。结果:超敏C反应蛋白(hypersensitive c-reactive protein,hs-CRP)、LP-PLA2、尿酸(uric acid,UA)是EH患者发生CKD的重要独立危险因素,其中UA是最重要的独立危险因素(OR:15.307, 95%CI:4.022~58.250,P<0.0001)。UA的标化偏回归系数b'绝对值最大(1.026),提示UA对EH患者发生CKD的影响最大。结论:UA、LP-PLA2、hs-CRP是EH发生CKD重要的独立危险因素,可能对CKD的预防和治疗提供新方向。
- 原发性高血压 /
- 慢性肾损害 /
- 炎性因子
Abstract: Objective: To discuss the level of serum inflammatory factors in patients with essential hypertension (EH) and chronic kidney damage (CKD), and analyze the relationship between inflammatory factors and related clinic factors in patients with EH and CKD. Method: A total of 127 patients diagnosed as EH were participated in the study. According to the target organs damages standard, all the patients were divided into two groups: Simple hypertension of 79 cases, hypertension with CKD of 48 cases. The clinical biochemical parameters and lipoprotein associated phospholipase A (Lp-PLA2) in each group were detected, and the related risk factors were also statistically analyzed. Result: Logistic regression analysis showed that there were 3 significant independent risk factors to promote for CKD in patients with EH, such as hypersensitive C-reactive protein, LP-PLA2, Uric Acid(UA). Moreover, UA was the major independent risk factors(OR:15.307, 95%CI:4.022-58.250,P<0.0001). The standardized partial regression coefficient b' of UA was the biggest (b':1.026), reminding that the effect of UA on the occurrence of CKD in patients with EH was the largest in the 5 evaluation factors. Conclusion: UA,LP-PLA2, hs-CRP were important independent risk factors for the occurrence of CKD in patients with EH. It may provide a new direction for the prevention and treatment of CKD.
- essential hypertension /
- chronic kidney damage /
- inflammatory factors

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参考文献(15)

[1]	廖玉华.心血管与炎症及自身免疫机制[J].临床心血管病杂志, 2003, 19 (4):193-193.
[2]	DIKALOV S L, UNGVARI Z.Role of mitochondrial oxidative stress in hypertension[J].Am J Physiol Heart Circ Physiol, 2013, 305:H1417-1427.
[3]	MIYAOKA T, MOCHIZUKI T, TAKEI T, et al.Serum uric acid levels and long-term outcomes in chronic kidney disease[J].Heart Vessels, 2014, 29:504-512.
[4]	RUBATTU S, PAGLIARO B, PIERELLI G, et al.Pathogenesis of target organ damage in Hypertension:Role of Mitochondrial Oxidative Stress[J].Int J Mol Sci, 2014, 16:823-839.
[5]	SARNAK M J, LEVEY A S, SCHOOLWERTH A C, et al.Kidney disease as a risk factor for development of cardiovascular disease:a statement from the American Heart Association Councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention[J].Hypertension, 2003, 42:1050-1065.
[6]	ARAUJO M, WILCOX C S.Oxidative stress in hypertension:Role of the kidney[J].Antioxid Redox Signal, 2014, 20:74-101.
[7]	SHANKAR A, SUN L, KLEIN B E, et al.Markers of inflammation predict the long-termrisk of developing chronic kidney disease:apopulation based cohort study[J].Kidney Int, 2011, 80:1231-1238.
[8]	KANG D H, NAKAGAWA T, FENG L, et al.A role for uric acid in the progression of renal disease[J].J Am Soc Nephrol, 2002, 13:2888-2897.
[9]	GRAYSON P C, KIM S Y, LAVALLEY M, et al.Hyperuricemia and incident hypertension:a systematic review and meta-analysis[J].Arthritis Care Res (Hoboken), 2011, 63:102-110.
[10]	SEDAGHAT S, HOORN E J, van ROOIJ F J, et al.Serum uric acid and chronic kidney disease:The role of hypertension[J].PLoS One, 2013, 8:e76827.
[11]	BOS M J, KOUDSTAAL P J, HOFMAN A, et al.Uric acid is a risk factor for myocardial infarction and stroke:the Rotterdam study[J].Stroke, 2006, 37:1503-1507.
[12]	BELLOMO G, VENANZI S, VERDURA C, et al.Association of uric acid with change in kidney function in healthy normotensive individuals[J].Am J Kidney Dis, 2010, 56:264-272.
[13]	KOSUGI T, NAKAYAMA T, HEINIG M, et al.Effect of lowering uric acid on renal disease in the type2diabetic db/db mice[J].Am J Physiol Renal Physiol, 2009, 297:F481-F488.
[14]	郑荔娴, 朱鹏立.降尿酸治疗与慢性肾脏病相关研究进展[J].临床心血管病杂志, 2016, 32 (3):303-305.
[15]	MAZALI F C, JOHNSON R J, MAZZALI M.Use of uric acid-lowering agents limits experimental cyclosporine nephropathy[J].Nephron Exp Nephro l, 2012, 120:e12-19.