LVEF正常的原发性高血压患者晨峰血压对早期肾功能损害的影响  

Effects of Morning Blood Pressure Surge of Normal EF% in Patients with Essential Hypertension on Early Renal Impairment and Correlation Analysis of Hcy and UmAlb

作　　者：张壬[1] 雷明明[1] 李小蕾[1] 王琦[1] 姚凤臣[1] 

机构地区：[1]中国医科大学附属第四医院心内科,辽宁沈阳110032

出　　处：《医学临床研究》2015年第4期767-770,共4页Journal of Clinical Research

摘　　要：【目的】探讨左心室射血分数（LVEF）正常的原发性高血压患者晨峰血压对早期肾功能损害的影响以及与同型半胱氨酸（Hcy）、尿微量白蛋白（UmAlb）的相关性。【方法】应用24 h动态血压监测仪器将197例原发性高血压且LVEF正常的患者依据晨峰血压水平分为两组：A组（晨峰血压正常组），共90例；B组（晨峰血压增高组）共107例。检测患者血尿素氮（BUN）、血清肌酐（SCr）、血尿酸（UA）、Hcy、UmAlb及血脂水平等指标。应用Pearson相关分析法和多元线性逐步回归法分析晨峰血压与肾功能、Hcy、UmAlb等指标的相关性。【结果】A组与B组患者在24 h、日间、夜间收缩压（SBP）和舒张压（DBP）的血压平均值，24 h平均动脉压（MAP）等方面均无显著性意义。B组在BUN、SCr、UA、Hcy和UmAlb水平方面均明显高于A组，差异有显著性意义（ P ＜0．05）。晨峰血压水平与BUN、SCr、UA、Hcy和UmAlb均显著相关（ P ＜0．05），其中晨峰血压与UmAlb相关性最强。【结论】晨峰血压在LVEF正常的原发性高血压患者所致早期肾功能损害方面有重要的意义，患者晨峰血压水平越高所致肾功能损害越重，且与Hcy、UmAlb密切相关，提示控制晨峰血压可降低患者早期肾功能损害程度。[Objective] To explore the effects of morning blood pressure surge （MBPS ） on early renal function impairment in essential hypertensive patients with normal left ventricular ejection fraction （EF% ） and examine the roles of homocysteine （Hcy） and urinary microalbumin （UmAlb） .[Methods] 24h ambulatory blood pressure monitoring （ABPM ） was performed for 197 inpatients of essential hypertension with normal EF% .Based upon MBPS ,they were divided into two groups of morning peak normotensive （A ,n=90） and morning peak blood pressure （B ,n=107） .The fasting blood specimens were collected within 24h after admission .An OLYMPUS AU640 automatic biochemical analyzer was used to measure the levels of blood urea nitrogen （BUN） ,serum creatinine （Scr） ,uric acid （UA） ,Hcy ,UmAlb and lipids .Pearson＇s correlation and multiple linear regression analyses were employed to examine the correlations between MBPS and renal function ,Hcy ,UmAlb and other parameters .[Results]No significant intergroup significance was found at 24h , daytime and nighttime averages of systolic blood pressure and diastolic blood pressure blood pressure or 24h mean arterial blood pressure （MAP） （ P 〉0 .05） .Group B were significantly higher than group A in the levels of BUN ,Scr ,UA ,Hcy and UmAlb （ P 〈 0 .05） .MBPS was significantly associated with BUN ,Scr , UA ,Hcy and UmAlb （ P 〈0 .05） .And MBPS and UmAlb had the strongest correlation （ r =0 .555 ,P =0 .000） .[Conclusion]MBPS plays important roles in early renal function damage for essential hypertensive patients with normal EF% .And it is closely correlated with Hcy and UmAlb .And a proper control of MBPS control may reduce early renal function damage .

关 键 词：高血压 心排血量 心室功能 左 血压 半胱氨酸 白蛋白尿 

分 类 号：R544.1[医药卫生—心血管疾病]