血清25-羟维生素D水平与原发性高血压病患者早期肾损害的关系研究  

Correlation between Serum 25-hydroxyvitamin D Level and Early Renal Damage in Patients with Essential Hypertension

作　　者：陈玉岚[1] 孙丽[1] 珠勒皮亚.司马义 徐新娟[1] 张向阳[1] 靳晨晨[1] 张俊仕[1] 

机构地区：[1]新疆医科大学第一附属医院高血压科,新疆乌鲁木齐市830054

出　　处：《中国全科医学》2013年第34期4052-4054,共3页Chinese General Practice

基　　金：国家自然科学基金资助项目(81160038);乌鲁木齐科学技术计划项目(Y111310003);新疆医科大学第一附属医院循证医学专项(2010XZ02)

摘　　要：目的探讨血清25-羟维生素D水平与原发性高血压病患者早期肾损害的关系。方法选取2010年5月—2013年3月在新疆医科大学第一附属医院高血压科住院的原发性高血压病患者280例。以25-羟维生素D<20μg/L界定为维生素D缺乏,根据血清25-羟维生素D水平将其分为两组:维生素D缺乏组(病例组)174例,非维生素D缺乏组(对照组)106例。收集患者的性别、年龄、高血压病程、血糖、血脂、血压及肾功能指标等,分析血清25-羟维生素D水平与各临床指标间的相关性。结果两组患者的性别、年龄、高血压病程、空腹血糖、三酰甘油、总胆固醇、平均收缩压、平均舒张压比较,差异均无统计学意义(P>0.05);病例组的平均脉压〔(49±10)mm Hg〕高于对照组〔(46±8)mm Hg〕,差异有统计学意义(P<0.05)。两组患者的24 h尿蛋白、尿素、肌酐、尿酸及血清胱抑素C水平比较,差异均无统计学意义(P>0.05);病例组的24 h尿微量清蛋白〔13.8(3.4,38.2)mg/24 h〕高于对照组〔9.0(1.7,19.3)mg/24 h〕,差异有统计学意义(P<0.05)。相关分析显示,血清25-羟维生素D与24 h尿微量清蛋白呈负相关(r=-0.135,P=0.032);血清25-羟维生素D与脉压呈负相关(r=-0.174,P=0.004)。结论血清25-羟维生素D缺乏与原发性高血压病患者早期肾损害有相关性,可能对肾小球的影响更显著。Objective To explore the correlation between serum 25 - hydroxyvitamin D level and early renal damage in patients with essential hypertension. Methods Retrospective study was performed in 280 inpatients diagnosed as having essential hypertension from May 2010 to March 2013. According to the serum 25 - hydroxyvitamin D level, all the patients were divided as 25 - hydroxyvitamin D deficiency （trial） group （ n = 174） （ serum 25 - hydroxyvitamin D 〈20 ug/L） and 25 - hydroxyvitamin D sufficiency （control） group （n = 106） . The clinical data and laboratory test results of the patients were collected and analyzed so as to investigate the correlation between serum 25 - hydroxyvitamin D levels and clinical indexes. Results There were no significant differences between the two groups in gender, age, course of hypertension, fasting blood glucose triglyceride, total cholesterol, average systolic and diastolic blood pressure （ P 〉 0.05 ） . The average pulse pressure in the trial group was （ 49 ± 10 ） mm Hg, being higher than （46 ± 8 ） mm Hg in the control group （ P 〈 0. 05 ） . No significant differences between the two groups were found in 24 - h proteinuria, serum urea, creatinine, uric acid and eystatin C （ P 〉 0. 05 ） . But the value of 24 - h urinary microalbumin was 13.8 （3.4, 38.2） mg in the trial group, being significantly higher than 9.0 （ 1.7, 19. 3） mg in the control group （ P 〈 0.05 ） . The multiple linear regression analysis showed 25 - hydmxyvitamin D level was negatively correlated with 24 - h microalbumininurine （r = -0. 135, P =0. 032） and pulse pressure （r = -0. 174, P =0. 004） . Conclusion Serum 25 - hydroxyvitamin D deficiency is associated with early renal damage in patients with essential hypertension, especially with impairment of the glomerulus.

关 键 词：高血压 25-羟维生素D 肾损害 关系 

分 类 号：R544.1[医药卫生—心血管疾病]