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目的探讨老年人卧位血压与尿微量白蛋白的关系。方法在参加开滦研究第3次健康体检的人群中,采取整群抽样的方法抽取年龄≥60岁的开滦集团离退休员工3064人,其中符合入选标准纳入统计分析者1692人。采用偏相关分析坐位、卧位、立位收缩压,舒张压与尿微量白蛋白的相关性,多因素Logistic回归分析卧位高血压对尿微量白蛋白的影响。结果观察对象1692人(男性1122人,女性570人),年龄为(67.3±6.2)岁,尿微量白蛋白为(25.9±43.5)mg/L。校正年龄、性别后,坐位、卧位、立位即刻、立位3min收缩压、舒张压均与尿微量白蛋白呈正相关。多因素Logistic回归分析显示:校正了年龄、性别等混杂因素后,坐位、卧位高血压是尿微量白蛋白增加的危险因素(坐位:OR=1.66,95%CI1.23~2.24;卧位:OR=1.48,95%CI 1.14~1.92),而立位高血压、立位低血压的相关性无统计学意义;坐位高血压、立位高血压、立位低血压、卧位高血压同时代入方程,并校正其他相同变量,坐位高血压是尿微量白蛋白增加的独立危险因素(OR=1.44,95%CI1.01~2.07),而卧位高血压、立位高血压、立位低血压的相关性无统计学意义。结论老年人坐位高血压与尿微量白蛋白增加相关性最大,卧位高血压次之,立位高血压或立位低血压与尿微量白蛋白增加相关性无统计学意义。
Objective To investigate the relationship between supine blood pressure and urinary albumin in the elderly. Methods Among the population who participated in the 3rd physical examination in Kailuan, a total of 3,064 retired staff of Kailuan Group aged 60 or older were enrolled in the study. Among them, 1692 were eligible for inclusion in the statistical analysis. Partial correlation analysis of sitting, lying position, standing systolic pressure, diastolic blood pressure and microalbuminuria, multivariate logistic regression analysis of supine hypertension on urinary albumin. Results A total of 1692 subjects (1122 males and 570 females) were observed, with a mean age of (67.3 ± 6.2) years and urine microalbumin (25.9 ± 43.5) mg / L. After adjusting for age and gender, sitting position, lying position, standing position immediately, stand 3min systolic blood pressure and diastolic blood pressure were positively correlated with urinary microalbumin. Multivariate Logistic regression analysis showed that sitting and lying-position hypertension were the risk factors for the increase of microalbuminuria after adjusting for age, sex and other confounding factors (sitting position: OR = 1.66,95% CI 1.23-2.24; OR = 1.48,95% CI 1.14-1.92), but there was no significant correlation between standing hypertension and standing hypotension. Sitting hypertension, standing hypertension, standing hypotension and supine hypertension were substituted into equation (OR = 1.44, 95% CI: 1.01 ~ 2.07), while lying-position hypertension, standing hypertension and standing hypotension were the independent risk factors for the increase of microalbuminuria Correlation was not statistically significant. Conclusion There is the highest correlation between sitting hypertension and urinary albumin in senile patients, followed by supine hypotension, standing hypertension or orthostatic hypotension with increasing urinary albumin.