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目的探讨诊室、随诊间、24h动态收缩压与老年人群肾脏损害的关系。方法 2006-2007年第1次对开滦集团公司在职及离退休职工进行健康体检,此后分别于2008-2009、2010-2011年进行第2、3次健康体检,并于第3次体检时整群随机抽取年龄≥60岁的开滦集团离退休员工2814人进行动态血压监测、尿微量白蛋白(MAU)测定等检查。符合入选标准共2464人。采用多因素线性回归分别分析诊室、随诊间、24h、白天、夜间收缩压与估算的肾小球滤过率(eGFR)、MAU的相关性。结果 2464名研究对象,男性1667人,女性797人,平均年龄67.4岁。按照不同收缩压三分位数分为3组,lgMAU随不同收缩压升高而增加,而eGFR随诊室、随诊间收缩压升高而降低。校正混杂因素后,多因素线性回归分析显示:诊室、随诊间、24h、白天、夜间收缩压均与MAU呈正相关,而只有随诊间收缩压与eGFR呈线性负相关。去除24h收缩压(存在多重共线性问题)后,比较诊室、随诊间、白天、夜间收缩压与eGFR、MAU相关性的回归结果显示,随诊间收缩压与eGFR呈负相关(B=-0.72,P=0.001),白天收缩压与MAU呈正相关(B=2.84,P=0.011)。结论诊室、随诊间、24h、白天、夜间收缩压与肾脏损害相关。
Objective To investigate the relationship between dynamic systolic blood pressure and renal damage in the elderly at clinic, at follow-up, 24h. Methods The first physical examination of serving and retired staff of Kailuan Group Company from 2006 to 2007 was carried out, and the second and third physical examination was carried out in 2008-2009 and 2010-2011, respectively. During the third physical examination, A total of 2,814 retired staff of Kailuan Group aged> 60 years were randomly selected for ambulatory blood pressure monitoring and urine microalbumin (MAU) test. Meet the inclusion criteria a total of 2464 people. Multivariate linear regression was used to analyze the correlation between systolic, follow-up, 24h, daytime and nighttime systolic blood pressure and estimated glomerular filtration rate (eGFR) and MAU. Results 2464 subjects, 1667 males and 797 females, with an average age of 67.4 years. Divided into three groups according to different systolic blood pressure, lgMAU increased with different systolic blood pressure increased, while eGFR decreased with attending clinics, systolic blood pressure increased with the clinic. After adjusting for confounding factors, multivariate linear regression analysis showed that there was a positive correlation between the systolic blood pressure at clinic, at the follow-up clinic, 24h, daytime and nighttime and MAU, while only the systolic blood pressure was negatively correlated with eGFR. After 24h systolic pressure removal (with multicollinearity), the correlation between systolic blood pressure, daytime and night systolic blood pressure and eGFR and MAU was negatively correlated with eGFR (B = - 0.72, P = 0.001). There was a positive correlation between daytime SBP and MAU (B = 2.84, P = 0.011). Conclusions Clinic, clinic, systolic blood pressure at night, 24h, 24h are related to renal damage.