老年高血压病动态血压与尿系列蛋白的关系  

Relationship between Ambulatory Blood Pressure and Excretion Rate of Proteinuria in Elderly Hypertensive Patients

作　　者：沈华[1] 李莹[1] 戴嘉[1] 吴寒[1] 

机构地区：[1]上海市第一人民医院国际医疗保健中心,上海200080

出　　处：《同济医科大学学报》2000年第1期79-80,83,共3页Acta Universitatis Medicinae Tongji

摘　　要：采用酶免疫法测定１００例老年高血压病和正常对照组３０倒尿转铁蛋白（Ｔｆ）、白蛋白（Ａｌｂ）、Ｎ－乙酰－β－Ｄ－氨基葡萄糖苷酶（ＮＡＧ）及视黄醇结合蛋白（ＲＢＰ），以及动态血压监测。结果：血压昼夜节律正常（Ａ组）４７例，异常（Ｂ组）５３例。 Ｂ组的 ２４ ｈ收缩压（ＳＢＰ）、夜间收缩压（ｎＳＢＰ）、夜间舒张压（ｎＤＢＰ）、收缩压负荷（ＳＢＰ－Ｌ）、舒张压负荷（ＤＢＰ－Ｌ）均明显高于Ａ组（Ｐ＜０．０５或＜０．０１），且Ｂ组的尿Ｔｆ、Ａｌｂ、ＩｇＧ、ＮＡＧ、ＲＢＰ显著升高（均为Ｐ＜０．０１）。结果表明，血压昼夜节律异常的患者夜间血压持续在较高的水平，具有较高的血压负荷，故肾脏损害严重。了解血压节律的变化，对预测高血压靶器官损害具有一定的意义。Urinary excretion rate of transferrin (Tf), albumin (Alb ), IgG, N-acetyl-beta-D- glucosaminidase activity (NAG), retinol-binding protein (RBP) were determined and 24-h ambulatory blood pressure measured in 100 elderly patients with essential hypertension and 30 normal subjects. The results showed that 47 patients had dipping of nocturnal blood pressure (group A), 53 patients had nondipping of nocturnal blood pressure (group B). The 24-h systolic blood pressure (SBP), nocturnal systolic blood pressure (nSBP) and diastolic blood pressure (nDBP), blood pressure load (SBP-L, DBP-L) in group B were significantly higher than those in group A (P<0. 05 or P<0. 01 ). And urinary excretion rate of Tf, Alb, IgG, NAG, RBP in group B were also significantly higher than those in group A (P<0. 01). It was indicated that the patients in nondipping group had a higher nocturnal blood pressure, higher blood pressure load and overt kindney damage. Loss of the normal nocturnal dip in blood pressure is associated with a greater risk of developing end-organ complications.

关 键 词：高血压 尿蛋白排泄 动态血压 老年人 

分 类 号：R544.1[医药卫生—心血管疾病]