高血压患者动脉僵硬度与尿白蛋白升高的关系  

Association between arterial stiffness and elevated albuminuria in hypertensive individuals

作　　者：田芸凡 彭澎 孙婧煜 钱雪松[2] 孙伟[1] 孔祥清[1] Tian Yunfan;Peng Peng;Sun Jingyu;Qian Xuesong;Sun Wei;Kong Xiangqing(Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Cardiology,The First People’s Hospital of Zhangjiagang,Zhangjiagang 215638,China)

机构地区：[1]南京医科大学第一附属医院心血管内科,210029 [2]张家港市第一人民医院心血管内科,215638

出　　处：《中国心血管杂志》2023年第2期159-164,共6页Chinese Journal of Cardiovascular Medicine

基　　金：中华国际医学交流基金会(Z-2019-42-2908)。

摘　　要：目的探讨社区高血压人群动脉僵硬度与尿白蛋白升高的相关性。方法2019年9月至2019年11月在江苏省张家港市南丰镇和大新镇选取年龄>45岁的786例高血压患者。根据臂踝脉搏波速度(baPWV)的四分位数分为四组,包括PWVⅠ组(PWV<1552.8 cm/s,197例)、PWVⅡ组(PWV为1552.8~1733.5 cm/s,196例)、PWVⅢ组(PWV为1733.6~1949.0 cm/s,196例)和PWVⅣ组(PWV>1949.0 cm/s,197例)。主要观察尿白蛋白升高,定义为尿白蛋白与肌酐比值(UACR)≥30 mg/g。以PWVⅠ组作为参照组,采用多因素logistic回归模型分别计算其他三组发生尿白蛋白升高的风险。进一步采用亚组分析探讨不同亚组间baPWV和尿白蛋白升高的相关性。结果与低baPWV者比较,高baPWV者的年龄偏大、男性偏多、饮酒者偏多、收缩压偏高、空腹血糖偏高、UACR水平更高(均为P<0.05)。Spearman相关性分析结果显示,baPWV和UACR水平呈正相关(rs=0.205,P<0.001)。单因素和多因素logistic回归分析均显示,baPWV与尿白蛋白升高显著相关(均为P<0.05)。调整变量后,以PWVⅠ组作为参考,PWVⅣ组的尿白蛋白升高的风险最高(OR=1.84,95%CI:1.10~3.10)。结论在高血压患者中,baPWV与尿白蛋白升高显著相关。Objective To investigate the association between arterial stiffness and albuminuria in in the community hypertensive population.Methods From September 2019 to November 2019,786 hypertensive participants over 45 years old in Nanfeng Town and Daxin Town,Zhangjiagang City,Jiangsu Province were included in this study.The study subjects were divided into four groups according to the quartile of brachial-ankle pulse wave velocity(baPWV):PWVⅠgroup(PWV<1552.8 cm/s,197 cases),PWVⅡgroup(PWV 1552.8-1733.5 cm/s,196 cases),PWVⅢgroup(PWV 1733.6-1949.0 cm/s,196 cases)and PWVⅣgroup(PWV>1949.0 cm/s,197 cases).The primary endpoint was elevated albuminuria,defined as urinary albumin to creatinine ratio(UACR)≥30 mg/g.Logistic regression analyses was performed to estimate the risk of elevated albuminuria among the four groups.Furthermore,subgroups analysis was used to explore the correlation between the baPWV and albuminuria.Results Compared with the PWV I group,those with higher PWV were older,had higher rates of males,drinkers,increased levels of systoli cblood pressure and fasting blood glucose and UACR(all P<0.05)Spearman correlation analyses showed that baPWV was positively correlated with UACR(rs=0.205,P<0.001).Univariate and multivariate logistic regression analyses both revealed that baPWV was significantly associated with albuminuria(both P<0.05).After adjusting variables,PWVⅣgroup was associated with the highest increased risk of elevated albuminuria compared with PWV I group(OR=1.84,95%CI:1.10-3.10).Conclusions BaPWV was positively correlated with elevated albuminuria among hypertensive participants.

关 键 词：动脉僵硬度 臂踝脉搏波速度 尿白蛋白/肌酐 尿白蛋白 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]