肾实质内小动脉血流动力学参数评估老年高血压患者预后的价值分析

摘要/Abstract

摘要： 目的探讨彩色多普勒超声进行肾实质内小动脉血流动力学参数评估对高血压老年患者预后的临床价值。方法选取2022年8月—2023年3月在江苏省省级机关医院诊治的88例原发性高血压老年患者,采用彩色多普勒超声检查所有患者的肾实质内小动脉血流动力学参数状况并进行相关性分析,判断患者的肾损伤发生情况。结果在88例患者中,发生肾损伤18例（肾损伤组）,发生率为20.45%;未发生肾损伤70例（非肾损伤组）,发生率为79.55%。肾损伤组患者的性别、年龄、血压、身体质量指数、心率等与非肾损伤组对比,差异无统计学意义（P>0.05）。肾损伤组患者的尿微量白蛋白、血肌酐、血尿素氮含量都显著高于非肾损伤组,差异有统计学意义（P<0.05）。肾损伤组患者的肾脏长度、肾皮质厚度、肾脏宽度均显著大于非肾损伤组,差异有统计学意义（P<0.05）。肾损伤组的肾实质内小动脉舒张末期血流速度、收缩期最大流速均低于非肾损伤组,搏动指数、阻力指数均高于非肾损伤组,差异有统计学意义（P<0.05）。在88例患者中,Spearman相关分析显示,肾损伤的发生与肾实质内小动脉舒张末期血流速度、收缩期最大流速、搏动指数、阻力指数都存在相关性（P<0.05）。结论原发性高血压老年患者并发肾损伤的概率比较高,使得患者的肾脏结构与肾实质内小动脉血流动力学参数发生改变,肾实质内小动脉血流动力学参数可评估患者的肾损伤预后情况。

关键词: 老年人, 原发性高血压, 肾损伤, 肾脏结构, 肾实质内小动脉, 血流动力学参数, 预后评估

Abstract: Objective To explore and analysis the prognostic values of hemodynamic parameters of renal parenchymal arterioles by color Doppler ultrasound in elderly patients with hypertension. Methods From August 2022 to March 2023, 88 cases of elderly patients with essential hypertension who were diagnosed and treated in a certain hospital were selected as the study subjects, all the cases to determine the occurrence of renal injury in the patients. The color Doppler ultrasound were used to examine the hemodynamic parameters of renal parenchymal arterioles in all patients, and correlation analysis were performed. Results In the 88 patients, there were 18 cases (20.45%) had renal injury. There were no significant differences in gender, age, systolic blood pressure, diastolic blood pressure, body mass index, and heart rate compared between the renal injury group and the non renal injury group (P>0.05). The levels of urinary microalbumin, serum creatinine, and blood urea nitrogen in the renal injury group were significantly higher than those in the non renal injury group (P<0.05). The renal length, renal cortical thickness, and renal width in the renal injury group were significantly increased compared with those in the non renal injury group (P<0.05). The end diastolic blood flow velocity and the maximum systolic flow velocity of the renal parenchymal arterioles in the renal injury group were lower than those in the non renal injury group (P<0.05), and the pulsation index and resistance index were significantly higher than those in the non renal injury group (P<0.05). In the 88 patients, Spearman correlation analysis showed that the occurrence of renal injury were correlated with end-diastolic blood flow velocity, maximum systolic flow velocity, pulsation index, and resistance index of renal parenchymal arterioles (P<0.05). Conclusion The probability of renal injury in elderly patients with essential hypertension is relatively high, which can cause changes in the renal structure and hemodynamic parameters of renal parenchymal arterioles. The hemodynamic parameters of renal parenchymal arterioles can evaluate the prognosis of patients with renal injury.

Key words: elderly, essential hypertension, renal injury, renal structure, renal parenchymal arterioles, hemodynamic parameters, prognostic evaluation

中图分类号:

R445.1

王会, 姜学忠, 刘小静, 何萍, 何睿. 肾实质内小动脉血流动力学参数评估老年高血压患者预后的价值分析[J]. 中华养生保健, 2024, 42(3): 38-41.

WANG Hui, JIANG Xue-zhong, LIU Xiao-jing, HE Ping, HE Rui. Evaluation of Prognostic Value of Hemodynamic Parameters of Renal Parenchymal Arterioles in Elderly Patients with Hypertension[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(3): 38-41.

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