原发性高血压患者血压变异性与早期肾功能损害相关性的初步探讨  

A preliminary study on relationship between blood pressure variability and early renal injury in patients with essential hypertension

作　　者：曹锐红 陈洁[1] 李献良 CAORuihong CHEN Jie LI Xianliang(Department of Cardiology, Zhangjiagang Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, 215600, China)

机构地区：[1]南京中医药大学附属张家港医院心血管科,江苏张家港215600

出　　处：《临床心血管病杂志》2017年第9期880-883,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨原发性高血压患者血压变异性(blood pressure variability,BPV)与早期肾功能损害的相关性。方法:对入选的102例原发性高血压患者行24h动态血压监测,晨尿微量白蛋白(microalbuminuria,MAU)及尿肌酐(urine creatinine,UCR)、肾功能、血糖及血脂检测。根据UACR(MAU与UCR的比值)分为2组:UACR在30~300 mg/g为MAU阳性组,UACR<30 mg/g为MAU阴性组。结果:(1)MAU检出率为28.4%;(2)2组患者在24hBPV、白昼BPV比较差异有统计学意义(P<0.05);(3)MAU与BPV的Pearson相关分析显示:MAU与24h夜间收缩压变异(systolic blood pressure variability,SBPV)、白昼SBPV高度正相关(r=0.784,P<0.001;r=0.739,P<0.001),与24h舒张压变异(diastolic blood pressure variability,DBPV)、白昼DBPV中度正相关(r=0.523,P<0.001;r=0.528,P<0.001);(4)logistic回归分析显示在未校正其他危险因素时,24hSBPV可以预测MAU的发生(OR=3.461,P<0.05),在校正了混杂因素后24hSBPV仍可以预测MAU的发生(OR=14.817,P<0.05)。结论:(1)高血压人群中MAU检出率高,在肾功能异常前出现,提示早期肾功能损害;(2)高血压患者BPV尤其是24hSBPV与MAU产生密切相关。Objective：To observe the relevance between blood pressure variability（BPV）and early renal dysfunction in patients with essential hypertension（EH）.Method：A total of 102 EH patients were recruited in this study and the 24 hambulatory blood pressures,morning urinary microalbumin（MAU）,urine creatinine,renal function,blood sugar,and blood lipid were recorded by detecting instrument.The patients were divided into two groups based on MAU to ereatinine ratio（UACR）：the MAU positive group（30UACR300mg/g）,and the MAU negtive group（UACR30mg/g）.Result：（1）Detection rate of MAU was 28.4%.（2）There were stastistical significances between 2 groups in 24 hBPV and daytime BPV（P〈0.05）.（3）Pearson correlation analysis of MAU and BPV showed：there was a high positive correlation between MAU and 24 hSBPV,daytime SBPV（r=0.784,P〈0.001;r=0.739,P〈0.001）,and there was a moderate positive correlation between MAU and 24 hDBPV,daytime DBPV（r=0.523,P〈0.001;r=0.528,P〈0.001）.（4）Logistic regression analysis showed that 24 hSBPV could predict the occurrence of MAU when no other risk factors are corrected（OR=3.461,P〈0.05）,and 24 h SBPV could also predict the occurrence of MAU after adjusting for confounding factors（OR=14.817,P〈0.05）.Conclusion：（1）The detection rate of MAU was higher in the patients with EH and the occur of MAU indicated early renal impairment in patients with EH.（2）BPV,especially 24 hSBPV,is closely related to MAU in patients with EH.

关 键 词：原发性高血压 血压变异性 尿微量白蛋白 

分 类 号：R544.1[医药卫生—心血管疾病]