| Objective:To study the correlation between red cell distribution width(RDW)and the early renal impairment index of non dipper hypertension : estimated renal glomerular filtration rate(e GFR),urine beta 2 microglobulin(beta 2-MG),and neutrophil gelatin-related lipoprotein(NGAL)in future clinical work,so as to provide some value for predicting renal impairment in patients with non-dipper hypertension in future clinical work.Method:Using retrospective analysis and research methods,317 patients with primary hypertension who were first admitted to cardiovascular medicine or nephrology at Nanchang University First Affiliated Hospital from January 2019 to January 2020 were collected.Collected general clinical data and laboratory results from hospitalization of 317 patients,including body mass index(Body Mass Index,BMI),red cell distribution width(RDW),hemocysteine(HCY),total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL),Low-density lipoprotein(LDL),human neutrophil gelatin-related lipoprotein(NGAL),uric acid(UA),creatinine(SCr),urea(BUN),beta 2 microglobulin(beta 2-MG),calculation of renal glomerular filtration rate(e GFR)based on the Cockcroft-Gaucroft formula,and ambulatory blood pressure monitoring results,Includes: 24 h mean systolic blood pressure(24h m SBP),24 h mean diastolic blood pressure(24h m DBP),diurnal mean systolic blood pressure(d SBP),diurnal mean diastolic blood pressure(d DBP),night mean diastolic blood pressuren(n SBP),night mean diastolic blood pressure(n DBP),blood pressure day and night variability SYS,blood pressure day and night variability DIA and other indicators,compared the differences between the two groups of indicators and the differences of RDW in different hypertension groups,HCY groups and renal injury groups were compared,and the correlation and regression analysis were used to understand the correlation between RDW and various renal function indicators in patients with non-hypertension and ROC curve was used to analyze the predictive value of RDW in evaluating early renal injury in patients with non dipper hypertension.Results:1.Two groups of patients(non dipper and dipper hypertension)of the general data comparison,RDW,HCY,NGAL,beta 2-MG,24 h m SBP,n SBP,n DBP in nondipper hypertension was higher than the dipper hypertension group(P<0.05),HDL,e GFR,blood pressure circadian variation rate SYS,blood pressure circadian variation rate DIA were lower than the dipper hypertension group(P<0.05).2.In patients with non dipper hypertension,RDW in different Hcy groups was significantly different between the two groups(P < 0.05),which was higher in the Hcy increased group than in the Hcy normal group.RDW in renal injury group was higher than that in normal group(P < 0.05);The RDW of hypertension grade 3 was higher than that of hypertension grade 2(P < 0.05),and that of hypertension grade 2was higher than that of hypertension grade 1(P < 0.05).3.Spearman-related analysis results show that: non-hypertension patients RDW and 24 h m SBP,n SBP,n DBP,HCY,NGAL,beta 2-MG positive correlation,and e GFR,HDL negative correlation.4.Multiple linear regression analysis showed that: RDW and e GFR,NGAL,β2-MG was related;Hcy is associated with EGFR.5.ROC curve analysis showed that the area under the curve(AUC)was 0.648(95% CI 0.576-0.721,P < 0.001).When RDW was 13.25,the sensitivity was 58.7%,and the specificity was 72.8%.Conclusion:1.RDW,NGAL,beta 2-MG in non dipper hypertension patients are higher than patients with dipper hypertension;e GFR in non dipper hypertension patients are lower than patients with dipper hypertension.2.RDW of non dipper hypertension was higher than that of dipper hypertension,and RDW of hypertension grade 3 was higher than that of hypertension grade 2,and that of hypertension grade 2 was higher than that of hypertension grade 1;RDW in Hcy increased group was higher than that in Hcy normal group;RDW in renal injury group was higher than that in normal group.3.RDW can be used as a predictor of early kidney damage in non-hypertension. |
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