原发性高血压病患者微量清蛋白尿与中心动脉压的关系研究  

Association between Microalbuminuria and Central Arterial Pressure in Patients with Essential Hypertension

作　　者：杨军[1] 许波[1] 秦晓伟[2] 蒲世军[1] 蒲国俭[1] 汪明[1] 

机构地区：[1]阆中市人民医院心内科,四川省南充市637400 [2]新疆医科大学第一附属医院高血压科

出　　处：《中国全科医学》2013年第26期3053-3056,共4页Chinese General Practice

摘　　要：目的探讨原发性高血压病患者中心动脉压与微量清蛋白尿(MAU)的关系。方法筛选2009年9月—2012年11月在新疆医科大学第一附属医院心脏中心住院的原发性高血压病患者204例,其中伴MAU阳性者95例(MAU组),MAU阴性者109例(对照组),分别测定其空腹血糖、血脂、肾功能、凝血功能、MAU水平。采用Sphygmocor脉搏波分析系统测定中心动脉相关指标:中心动脉收缩压(CSP)、中心动脉脉压(CPP)、增强压(AP)、反射波增强指数(AIX)、泵血时间(ED)和心内膜下心肌活力率(SEVR),分析其与MAU的相关性和影响因素。结果两组患者的高血压病程、高血压家族史及纤维蛋白原、尿素、尿酸、收缩压、舒张压水平比较,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,MAU与CSP、CPP、AP呈正相关(r=0.32,P<0.01;r=0.189,P<0.01;r=0.149,P<0.05);多元逐步回归分析显示,CSP、纤维蛋白原、收缩压进入回归方程。结论 CSP、CPP、AP是MAU发生的危险因素,其升高可导致MAU增高。Objective To investigate the relationship between microalbuminuria （MAU） and central aortic pressure in patients with essential hypertension （EP）. Methods A total of 204 EP patients admitted to First Affiliated Hospital of Xin- jiang Medical University from September 2009 to November 2012 were divided into groups A （ positive MAU, n = 95 ）, B （MAU negative, n = 109）. Levels of fasting blood glucose （FBG）, blood lipids, renal function, blood coagulation, MAU were detected. Sphygmocor pulse wave analysis system was used to determine central artery related indicators such as central sys- tolic pressure （ CSP）, central pulse pressure （ CPP）, augmentation pressure （ AP）, reflected wave augmentation index, blood pumping time and subendocardial viability ratio （SEVR）. Their correlation with MAU and influencing factors were ana- lyzed. Results There was significant difference in hypertension course, family history, fibrinogen, urea, uric acid, SBP, DBP, creatinine level between 2 groups （P 〈 0. 05）. By Pearson correlation analysis, MAU was positively correlated with CSP, CPP, AP （r=0.32, P〈0.01; r=0.189, P〈0.01; r=0.149, P〈0.05）; By multiple regression analysis, CSP, fibrin- ogen, SBP entered into the regression equation. Conclusion CSP, CPP, AP, risk factors of MAU, can lead to elevated MAU when they increase.

关 键 词：高血压 白蛋白尿 中心动脉压 

分 类 号：R544.11[医药卫生—心血管疾病]