高血压；_肾功能衰竭；

高血压伴肾功能不全57例临床研究

http://www.100md.com 《实用老年医学》 2000年第1期

高血压；,肾功能衰竭；,研究,【主题词】高血压；肾功能衰竭；研究,1资料与方法,2结果,3讨论,参考文献

     【摘要】目的探讨高血压合并肾功能不全病人的降压效果及血压不达标的影响因素。方法收集高血压合并肾功能不全的57例病人，选取同期住院的不伴肾功能不全的高血压病人59例作为对照。比较2组病人降压药应用及血压达标情况。分析高血压合并肾功能不全病人的肾功能不全形成原因及血压不达标的影响因素。结果 (1)肾功能不全的病因构成比：高血压肾病占596%，糖尿病肾病占351%，其他53%。(2)高血压伴肾功能不全病人应用降压药种类明显多于单纯高血压患者(P<001)。按血压<140/90 mmHg的标准，高血压伴肾功能不全组和单纯高血压组的血压达标率分别为702%和915%(P<001)。(3)按血压<130/80 mmHg的标准，高血压伴肾功能不全组血压达标率为596%，未达标率404%，单因素分析显示，基线肌酐水平高、血压水平高、钠水潴留是未达标的危险因素；多元Logistic回归结果显示，钠水潴留(P<001)和基线肌酐水平高(P<001)达到统计学显著性。结论 (1)高血压伴肾功能不全病人的血压达标率明显低于不伴肾功能不全的高血压病人。(2)钠水潴留和肌酐水平高是高血压伴肾功能不全的血压不达标的独立危险因素。

     【主题词】高血压；肾功能衰竭；研究

    Study on antihypertensive therapy for hypertension patients with renal insufficiency

    HUANG Guangyong,LU Caiyi,ZHAO Yusheng,WU Xingli,WANG Shiwen.

    Institute of Geriatric Cardiology,Chinese PLA General Hospital,Beijing 100853 China

    【Abstract】 Objective To explore the antihypertensive therapy effect on hypertension with renal insufficiency and explore the influencing factors for failure to lower blood pressure to normal. Methods Fiftyseven hypertension patients with renal insufficiency (case group) and 59 hypertesion patients without renal insufficiency (control group)were collected.The two groups were compared in the administration of antihypertensive drugs and their blood pressures.The causes of renal insufficiency were analysed and the influencing factors for failure in lowering the blood pressure to normal were discussed. Resukts (1)Hypertension and diabetes were the main etiology accounting for renal insufficiency.(2)The average kinds of antihypertensive drugs used for renal insufficiency were more than those for controls (P<001).However,the rate of hypertention lowering to meet the normal(140/90 mmHg) in case group was markedly less than that in control group(P<001).(3)In renal insufficiency,the rates of hypertention lowering to meet the normal(130/80 mmHg)or not were 596% and 404% respectively.Excess volume (P<001) and elevated serum creatinine(P<001) were influencing factors for failure to meet the standard. Conckusions Elevated blood pressure in hypertension with renal insufficiency is relatively difficult to control compared with hypertention without renal insufficiency.Excess sodiumwater volume is pivotal factor in hypertension with renal insufficiency. ......

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