尿酸、尿微量白蛋白肌酐比与肾性高血压患者动态血压参数的相关性分析  

Correlation analysis of uric acid,urinary microalbumin creatinine ratio and dynamic blood pressure parameters in patients with renal hypertension

作　　者：何金森 卢林琪 HE Jin-sen;LU Lin-qi(Department of Nephrology,Nanping First Hospital Affiliated to Fujian Medical University,Nanping 353000,Fujian,China)

机构地区：[1]福建医科大学附属南平第一医院肾内科,福建南平353000

出　　处：《川北医学院学报》2024年第10期1321-1324,共4页Journal of North Sichuan Medical College

基　　金：福建省自然科学基金项目(2020J011316);福建医科大学启航基金项目(2019QH1226)。

摘　　要：目的:分析肾性高血压患者血清尿酸(SUA)、尿微量白蛋白肌酐比(UACR)与24 h动态血压参数的相关性。方法:纳入肾性高血压患者(n=58)及原发性高血压患者(n=58)为研究对象并分为肾性高血压组和原发性高血压组。测定两组患者SUA、UACR水平,监测其24 h动态血压参数[24 h平均收缩压(24 hSBP)、24 h平均舒张压(24 hDBP)、白天平均收缩压(dSBP)、白天平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)]。采用Pearson法分析肾性高血压患者SUA、UACR与24 h动态血压参数的相关性。采用ROC曲线评估具有差异的指标对肾性高血压与原发性高血压的诊断效能。结果:肾性高血压组患者SUA、UACR均高于原发性高血压组(P<0.05)。肾性高血压组患者24 hSBP、24 hDBP、nSBP、nDBP均高于原发性高血压组(P<0.05)。肾性高血压患者SUA与24 hSBP、dSBP、nSBP均呈正相关关系(P<0.01)。肾性高血压患者UACR与24 hSBP、24 hDBP、nSBP、nDBP均呈正相关关系(P<0.05)。经ROC分析,当SUA≥399.740μmol/L时,鉴别诊断的灵敏度为0.655,特异度为0.741;当UACR≥96.230 mg/g时,灵敏度为0.672,特异度为0.621;当24 hSBP≥139.50 mmHg时,灵敏度为0.707,特异度为0.724;当24 hDBP≥92.50 mmHg时,灵敏度为0.690,特异度为0.724;当nSBP≥136.50 mmHg时,灵敏度为0.621,特异度为0.707;当nDBP≥91.50 mmHg时,灵敏度为0.741,特异度为0.707;六者联合诊断的灵敏度为0.862,特异度为0.845。结论:与原发性高血压相比,肾性高血压患者肾损伤程度及血压波动范围更大,昼夜节律减弱,且肾性高血压患者SUA、UACR与24 h动态血压参数正相关;可将其联合用于肾性高血压与原发性高血压的鉴别诊断。Objective:To analyze the correlation between serum uric acid(SUA),urinary microalbumin creatinine ratio(UACR)and 24 h ambulatory blood pressure parameters in patients with renal hypertension.Methods:Patients with renal hypertension(n=58)and essential hypertension(n=58)were included as the study objects and they were divided into renal hypertension group and essential hypertension group.SUA and UACR levels were detected in the two groups.24 h ambulatory blood pressure parameters[24 h mean systolic blood pressure(24 hSBP),24 h mean diastolic blood pressure(24 hDBP),daytime mean systolic blood pressure(dSBP),daytime mean diastolic blood pressure(dDBP),night mean systolic blood pressure(nSBP),night mean diastolic blood pressure(nDBP)]were monitored.Pearson correlation coefficient was used to analyze the correlation between SUA,UACR and 24 h ambulate blood pressure parameters in patients with renal hypertension.Evaluate the differential diagnostic efficacy of indicators with differences in renal hypertension and primary hypertension by drawing ROC curves.Results:SUA and UACR in renal hypertension group were higher than those in essential hypertension group(P<0.05).24 hSBP,24 hDBP,nSBP and nDBP in renal hypertension group were higher than those in essential hypertension group(P<0.05).In renal hypertension patients,SUA was positively correlated with 24 hSBP,dSBP and nSBP(P<0.01),UACR in patients with renal hypertension was positively correlated with 24 hSBP,24 hDBP,nSBP and nDBP(P<0.05).After ROC analysis,when SUA≥399.740μmol/L,the sensitivity and specificity of differential diagnosis between renal hypertension and primary hypertension were 0.655 and 0.741,when UACR≥96.230 mg/g,the sensitivity was 0.672 and the specificity was 0.621,when SBP≥139.50 mmHg for 24 hours,the sensitivity was 0.707 and the specificity was 0.724,when the DBP≥92.50 mmHg for 24 hours,the sensitivity was 0.690 and the specificity was 0.724,when nSBP≥136.50mmHg,the sensitivity was 0.621 and the specificity was 0.707,when nDBP≥91.50 mmH

关 键 词：尿酸 尿微量白蛋白肌酐比 肾性高血压 原发性高血压 动态血压参数 

分 类 号：R544.14[医药卫生—心血管疾病] R544.1[医药卫生—内科学]