首页|尿素氮肌酐比联合尿酸水平对老年高血压肾病的早期预测价值

尿素氮肌酐比联合尿酸水平对老年高血压肾病的早期预测价值

Blood urea nitrogen/creatinine ratio combined with uric acid level for Early prediction of nephropathy in elderly hypertensive patients

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目的 探讨尿素氮肌酐比联合尿酸水平对老年高血压患者并发肾损伤的早期预测价值,为早期评估老年高血压肾病的发生风险提供依据.方法 纳入2022年1月-2022年7月于宁波大学附属第一医院健康管理中心体检的老年高血压患者867例作为观察对象.对所有对象进行随访,将随访1年内发生高血压肾病的44例患者纳入观察组,未发生的823例患者纳入对照组.比较两组患者血压、血尿素氮、肌酐、尿酸等高血压肾病相关临床资料,使用Cox回归分析高血压肾病的危险因素;使用ROC曲线分析尿素氮肌酐比、尿酸单独和联合预测高血压肾病的价值;绘制限制性立方样条以拟合联合预测指标与高血压肾病的非线性关系.结果 观察组患者低密度脂蛋白胆固醇、尿素氮肌酐比值和血尿酸水平高于对照组患者,差异有统计学意义(P<0.05).Cox回归分析结果显示,尿素氮肌酐比值和血尿酸水平升高是老年高血压患者并发高血压肾病的独立危险因素.两项指标联合检测预测高血压肾病的AUC为0.736,约登指数为0.587,均大于两项指标单独检测.在节点为4的条件下,早期联合检测指标与患者发生高血压肾病呈非线性相关(P<0.05).结论 血尿素氮肌酐比和尿酸水平均可以在一定程度上反映老年高血压患者早期肾功能损伤.将上述两项指标用于早期预测该人群高血压肾病的发生风险,有助于临床工作者对高危人群进行针对性干预,达到对高血压肾病早期防治的效果,改善患者预后.
Objective To explore the early predictive value of blood urea nitrogen/creatinine ratio(BUN/Cr)combined with uric acid level for nephropathy in elderly hypertensive patients.Methods A total of 867 elderly hypertensive patients who underwent physical examination in the Health Management Center of the First Affiliated Hospital of Ningbo University from January 2022 to July 2022 were enrolled.During the one year's followed-up,hypertensive nephropathy developed in 44 cases(case group),and other 823 cases served as the control group.The blood pressure,blood urea nitrogen,creatinine,uric acid levels and urinary protein were compared between the two groups.The risk factors of hypertension nephropathy were analyzed by binary Cox regression.The value of BUN/Cr,uric acid and in combination for predicting hypertension nephropathy was analyzed by the ROC curve.Drew a constrained cubic spline to fit the nonlinear relationship between combined index and prognosis.Results The LDL-cholesterol,BUN/Cr and blood uric acid level in the case group were significantly higher than those in the control group(P<0.05).Cox regression analysis showed that the increase of BUN/Cr and blood uric acid level were independent risk factors of hypertensive nephropathy in elderly hypertensive patients.The AUC and Yoden index of BUN/Cr combined with blood uric acid for predicting hypertensive nephropathy were 0.736 and 0.587 respectively,which were higher than those of the two single indexes.Under the condition of node 4,the early combined index was nonlinearly correlated with the occurrence of elderly hypertensive nephropathy(P<0.05).Conclusion BUN/Cr and uric acid level can reflect the early renal function damage in elderly patients with hypertension to a certain extent.Applying the above two indicators,particularly the combination of two may be used for early predicting the risk of hypertensive nephropathy in this population.

hypertensionchronic kidney diseaseurea nitrogencreatinineuric acid

王骥、徐晓、沈玉芹

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同济大学医学院,上海 200092

宁波大学附属第一医院宁波市干部保健中心,浙江宁波 315010

同济大学附属同济医院心脏康复中心,上海 200065

高血压 慢性肾脏病 尿素氮 肌酐 尿酸

国家科学自然基金面上项目上海市先进适宜技术推广项目

819743592019SY014

2024

同济大学学报(医学版)
同济大学

同济大学学报(医学版)

CSTPCD
影响因子:0.51
ISSN:1008-0392
年,卷(期):2024.45(4)