Study On The Correlation Between The Degree Of Renal Damage And Serum HS-CRP,γ-GT And Hcy Levels In Elderly Patients With Hypertension

Objective: To analyze the correlation between the severity of hypertensive renal damage and serum h S-CRP,γ-GT and Hcy in elderly patients,so as to provide clinical basis for serological indicators to predict the risk of hypertensive renal damage.Methods: A total of 260 elderly patients over 65 years old with hypertension who were hospitalized in the Department of General Medicine and the Department of Nephrology in the First Affiliated Hospital of China Medical University from September 2016 to June 2019 were collected,and the follow-up time was more than 3months.Among them,150 cases were male and 110 cases were female,and the patients had complete clinical data during hospitalization.Clinical analysis was carried out on the patients.According to the examination results of the patients,they were divided into 2 groups,180 cases were hypertensive renal injury,and 80 cases were control group.Patients were further divided into 5 groups based on the glomerular filtration rate(GFR)grading of renal impairment from mild to severe,and these 5 groups were classified into CKD1,CKD2,CKD3,CKD4,and CKD5 respectively.SPSS22.0 software was used for statistical analysis,including T test,Chi-square test,single-factor analysis,multi-factor analysis,difference analysis,Spearman rank correlation analysis and Pearson correlation analysis.Results: 1.There were no significant differences in age,male,BMI,smoking history,duration of hypertension,diastolic blood pressure,TC,TG and D-D between the two groups(P > 0.05).Systolic blood pressure,Hcy,LDL-C,HDL-C,γ-GT and hs-CRP were significantly different between the two groups(P < 0.05).2.The comparison of risk factors of different degrees of kidney damage showed that the case group was divided into 5 stages according to the degree of kidney damage,including 31 patients in stage 1,40 patients in stage 2,40 patients in stage 3,37 patients in stage 4 and 32 patients in stage 5.In this study,it was found that the degree of renal damage was different in systolic blood pressure,Hcy,LDL-C,HDL-C,γ-GT and hs-CRP,and the differences were statistically significant(P < 0.05).The results of variance analysis showed that the degree of renal damage increased with the increase of systolic blood pressure,LDL-C and γ-GT.Hcy,HDL-C,h S-CRP and other indicators were related to the degree of renal damage,but there was no continuous change.3.Correlation analysis of risk factors of hypertension complicated with renal damage shows that: Hypertension complicated with renal damage was correlated with systolic blood pressure,Hcy,LDL-C,HDL-C,γ-GT and hs-CRP,etc.Hdl-c was negatively correlated with hypertension complicated with renal damage,while other indicators were positively correlated with hypertension complicated with renal damage.Systolic blood pressure and Hcy had stronger correlation with hypertension complicated with renal damage than other indicators(R > 0.2).4.Correlation analysis of risk factors of different degrees of kidney damage showed that Hcy was significantly correlated with stage 1 kidney damage(P < 0.05).Systolic blood pressure,Hcy and HDL-C were significantly correlated with stage 2 renal injury(P < 0.05).Systolic blood pressure,Hcy,HDL-C,γ-GT and hs-CRP were significantly correlated with stage 3 renal injury(P < 0.05).Systolic blood pressure,Hcy,LDL-C and γ-GT were significantly correlated with stage 4 renal injury(P < 0.05).Systolic blood pressure,Hcy,LDL-C,HDL-C,γ-GT and hs-CRP were significantly correlated with stage 5 renal injury(P <0.05).5.The corresponding AUC values of Hcy,γ-GT and hs-CRP were 0.670,0.607 and 0.595,respectively,suggesting that the diagnostic value of Hcy,γ-GT and hs-CRP for renal damage was relatively low.The CORRESPONDING AUC value of combined diagnosis was 0.715(95%CI :0.643-0.783),indicating that combined diagnosis has relatively high diagnostic value for nephropathy.Conclusion: Systolic blood pressure,Hcy,LDL-C,HDL-C,γ-GT and Hs-CRP are related influencing factors of hypertension complicated with renal damage.Hdl-c is a protective factor of hypertension combined with renal damage,while systolic blood pressure,Hcy,LDL-C,γ-GT and hs-CRP are risk factors of hypertension combined with renal damage.The higher the systolic blood pressure,LDL-C and γ-GT,the more likely the kidney damage was.The combined detection of Hcy,γ-GT and Hs-CRP has high diagnostic value in renal damage of elderly patients with hypertension,and can be used for early monitoring of elderly patients with hypertension.