Value of ultrasound combined with ABPM in evaluating early renal damages in elderly hypertensive patients(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2021年第3期
- Page:
- 331-336
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Value of ultrasound combined with ABPM in evaluating early renal damages in elderly hypertensive patients
- Author(s):
- DAI Jinglan; HUA Lei; LI Duo; MOU Haigang
- Department of Cardiology, No.958 Hospital of PLA, Chongqing 400020, China
- Keywords:
- Keywords: hypertension early renal damage ultrasound ambulatory blood pressure monitoring
- PACS:
- R4451；R692
- DOI:
- DOI:10.3969/j.issn.1005-202X.2021.03.012
- Abstract:
- Abstract: Objective To explore the clinical value of ultrasound combined with 24 h ambulatory blood pressure monitoring (ABPM) in the evaluation of early renal damages in elderly hypertensive patients. Methods A total of 102 elderly patients with essential hypertension were enrolled in the study, including 55 cases with early renal damages in group A, and 47 cases without early renal damages in group B. Meanwhile, 50 healthy elderly subjects were selected and included in group C. The 24 h ambulatory blood pressure and renal ultrasound blood flow parameters of the 3 groups were compared. Moreover, multiple stepwise regression analysis and ROC curve analysis were performed. Results The 24 h mean systolic blood pressure (SBP), 24 h mean diastolic blood pressure (DBP), diurnal mean SBP, diurnal mean DBP, nocturnal mean SBP, nocturnal mean DBP, SBP loading value and DBP loading value of group A were all higher than those of group B and group C (P<0.05). The SBP smoothing index and DBP smoothing index of group A were lower than those of group B and group C (P<0.05), but the SBP variability coefficient was higher than that of group B and group C (P<0.05). Compared with those in group B and group C, the percentage of dipper type hypertension was lower in group A (P<0.05), while the percentages of nondipper type hypertension and reverse dipper type hypertension were higher (P<0.05). The ultrasound blood flow resistance indexes (RI) of renal segmental arteries and interlobular arteries in group A were higher than those of group B and group C (P<0.05). Regression analysis found that SBP smoothing index, SBP variability coefficient, non dipper type hypertension, reverse dipper type hypertension and RI of renal segmental arteries were independent risk factors of early renal damages in elderly hypertensive patients. The sensitivity, specificity and accuracy of ultrasound combined with ABPM in the prediction of early renal damages of hypertension were 85.45%, 90.72% and 88.82%, respectively, which revealed that the diagnosis by the proposed method was highly consistent with the actual clinical diagnosis (Kappa=0.759). Conclusion Ultrasound combined with ABPM is of great value in predicting early renal damages of hypertension which can be evaluated based on renal ultrasound blood flow RI, ABPM smoothing index and variability coefficient. Nondipper type hypertension and reverse dipper type hypertension will increase the risk of early renal damages.
Last Update: 2021-03-30