血清脂联素水平与原发性高血压患者肾脏损害的关系  

The relationship between serum adiponectin and kidney function in patient of essential hypertension

作　　者：崔洪伟[1] 王敏[1] 董秀红[1] 柴春香[1] 杨丽梅[1] 刘霞[1] 

机构地区：[1]潍坊医学院附属医院急诊科,山东省潍坊市261031

出　　处：《中国医药》2009年第12期961-964,共4页China Medicine

摘　　要：目的探讨血清脂联素水平与原发性高血压（EH）患者。肾脏损害的关系。方法选择我院确诊为EH的门诊及住院患者60例（EH组33，以及体质指数（BMI）、年龄、性别匹配的健康体检者60例（对照组）。用酶联免疫吸附（ELISA）法检测其血清脂联素浓度；用放射免疫法（RIA）测定尿微量白蛋白（MA）浓度，计算24h尿白蛋白排泄量（UAE）；进行24h动态血压监测（ABPM）及常规的临床和实验室指标的检测。EH组以UAE值为基础，分为MA（-）／EH亚组和MA（＋）／EH亚组。采用SPSS11．5统计软件进行统计分析。结果EH组脂联素浓度不呈正态分布，取其对数值进行统计学分析。EH组lg（脂联素浓度）为（0．96±0．21）mg／L，对照组为（1．06±0．16）mg／L，组间比较差异有统计学意义（t=2．934，P〈0．01）。EH组UAE〈30mg／24h20例，30—300mg／24h40例，2组lg（脂联素浓度）与UAE呈显著负相关（r=-0．532，P〈0．01），校正各因素后仍呈显著负相关（偏相关系数r=-0．279，P=0．036）。EH组中动态血压节律杓形34例，非杓形26例，UAE分别为（21．17±11．08）mg／24h和（28．20±12．48）mg／24h，差异有统计学意义（t=2．280，P〈0．05），2组lg（脂联素浓度）差异无统计学意义。结论EH患者血清脂联素浓度低于正常对照者，低脂联素血症与EH的发生、发展有一定关系。EH患者中，MA伴有血清脂联素浓度的降低。低脂联素血症与EH患者MA的发生密切相关，脂联素可能有保护EH患者肾脏以及血管内皮功能的作用。血压昼夜节律异常促进了MA的发牛。Objective To investigate the relationship between serum adiponectin and kidney function in patient ofessential hypertension（EH）. Methods We conducted a case -controul study of 60 EH patient（ EH group） and 60 normal subjects of the same body mass index（BMI） ,sxe and age （control group）. Serum adiponectin levels was assessed by enzyme linked immunosorbent assay （ELISA） and microalbumin was detected by radioimmunoassay （RIA）, 24-hour urinary albumin excretion （UAE） was calculated. Ambulatory blood pressure monitoring were recorded and other routine parameters about clinical and laboratory were assessed. According to UAE, we divided EH group into MA（ - ）/EH groups who had normal albuminuria（n =40, UAE 〈30 mg/24 h） and MA（ ＋ ）/EH group who had microalbuminuria（ n = 20,30 ≤ UAE 〈 300 mg/24 h）. Results The lg（adiponectin） values in EH group is significantly lower than control group （t =2. 934,P 〈0.01 ）. In EH group, there was a negative correlation between lg（adiponectin） and UAE（r = -0.532,P 〈0.01 ）. Subjects who had microalbminuria in EH group had abnormal circadian rhythm of blood pressure. There was a significantly difference between non - dipper EH group and dipper EH group regarding the UAG （ t = 2. 280, P 〈 0.05）. Conclusion The hypo-adiponectinemia is one of the risk factors for EH. There is a correlation between hypo-adiponectinemia and the microalbuminuria, therefore adiponectin may be a protective factor of renal dysfunction. The abnormality of rhythm of blood pressure can induce microalbuminuria in patient with EH.

关 键 词：原发性高血压 脂联素 微量白蛋白 动态血压监测 

分 类 号：R544[医药卫生—心血管疾病]