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首页> 中文期刊> 《安徽医科大学学报》 >华东地区农村高血压人群吸烟与肾功能下降的关系

华东地区农村高血压人群吸烟与肾功能下降的关系

         
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Objective To investigate the effect of smoking on renal function decline in rural hypertensive popula-tion residing in Eastern China , and provide a preliminary basis for early prevention of chronic kidney disease . Methods 20 702 subjects with hypertension aged 45~75 years old were enrolled .Cigarette smoking was collected by standardized questionnaire;renal function was estimated by glomerular filtration rate ( GFR) using the CKD-EPI formula .Results A total of 20 312 participants ( 60.0 ±7.5 years of age ) were the final subjects in the study . Logistic regression analysis showed that compared with non-smokers, the prevalence of renal function decline was significantly higher in current smokers (2.5%vs 1.8%, OR=1.42, 95%CI:1.05~1.92, P=0.022) and for-mer smokers(3.6%vs 1.8%, OR=1.50, 95%CI:1.04 ~2.17, P=0.030) after adjusting for study center , gender, age, body mass index, blood pressure, serum lipids, history of diabetes mellitus, taking antihypertensive drugs and alcohol consumption .Meanwhile , cigarette smoking and elevated blood pressure ( systolic blood pressure≥21.28 kPa vs <21.28 kPa, P value for interaction was 0.006) had a synergistic effect in prevalence of renal function decline .Conclusion Cigarette smoking ( both current and former smokers ) is significantly associated with the renal function decline in hypertensive patients .Elevated blood pressure levels and smoking have a synergistic effect on prevalence of renal function decline .It prompts that smokers who have a more stringent blood pressure control could reduce the early injury of renal target organs .%目的：探讨我国华东地区（安庆及连云港）农村高血压人群吸烟与肾功能下降的关系，为慢性肾脏病的早期预防提供初步依据。方法选取20702例45～75周岁的高血压患者。通过问卷调查收集研究对象的吸烟状况；根据CKD-EPI公式估算肾小球滤过率（ GFR）以评估肾功能。结果20312例受试者纳入最终分析，受试者平均年龄为（60.0±7.5）岁。调整地区、性别、年龄、体质指数、血压、血脂、是否患糖尿病、是否服用降压药物以及饮酒等因素后，与从不吸烟者比较，现在吸烟者（2.5％ vs 1.8％，OR＝1.42，95％CI：1.05～1.92，P＝0.022）、曾经吸烟者（3.6％ vs 1.8％，OR＝1.50，95％CI：1.04～2.17，P＝0.030）肾功能下降（eGFR＜60 ml／min／73m2）的患病率均显著增加；同时，吸烟与血压水平升高（收缩压≥21.28 kPa vs ＜21.28 kPa，交互作用P＝0.006）在导致肾功能下降患病率增加具有显著协同作用。结论现在或曾经吸烟的高血压患者肾功能下降的患病率显著增加。血压水平升高与吸烟在导致肾功能下降患病增加具有协同作用。提示吸烟者更为严格的血压控制可以减轻肾脏靶器官的早期损害。

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