原发性高血压患者尿Alb、IgG、IgA、IgM及清除率变化意义的探讨  

Comparison of the patients with essential hypertension and normal subjects on urinary excretion rate and clearance of albumine and immunoglobulines

作　　者：郭冀珍[1] 钱文琪[1] 高平进[1] 张慧丽 唐树德[1] 龚兰生[1] 张桂生[2] 谢有娣[2] 屠国康[2] 

机构地区：[1]上海第二医科大学上海市高血压病研究所,200025 [2]上海第二医科大学科技中心实验室

出　　处：《临床心血管病杂志》1992年第2期66-69,共4页Journal of Clinical Cardiology

摘　　要：本文对80例正常人与120例原发性高血压患者,常规尿检验蛋白阴性或微量,用精确的定量法测定尿微量Alb及IgG、A、M浓度.发现高血压患者尿内上述蛋白排泄率均明显高于正常人,分别为P<0.001、P<0.01、P<0.01、P<0.01,其中Alb、IgG与测定时血压相关(SBP与尿Alb:P<0.01,DBP与尿Alb:P<0.05,DBP与尿IgG:P<0.05).用IgG清除率/alb清除率配对比较发现原发性高血压患者的比值明显高于正常人(P<0.001)。进一步将高血压患者按WHO标准分成三期,发现此比值进行性减低(分别为1.47±2.06,1.11±1.04,0.895±0.81;与正常人比分别为P<0.2,P<0.001,P<0.02)。上述结果可见原发性高血压患者有明显升高的尿IgG、Alb排泄率,并与血压相关,随着高血压病进一步发展,从Ⅰ期～Ⅲ期,尿白蛋白排泄率进行性增加,其增加程度比IgG更明显,提示尿Alb是高血压病引起血管损伤及肾血管早期病变的敏感指标。In 120 untreated patients with essential hypertension and 80 normal subjects, who all had negative or trace proteinuria in routine examination, unriary excretion rates and clearances of albumin and 1gG, 1gA, 1gM were examined by ELTA. Urinary excretion rates of albumin (A1b), and 1gG, A, M in essential hypertension were significantly higher than those in normal subjects (P<0.001, P<0.01, P<0.01, P<0.01, respectively). There were positive correlations between urinary A1b excretion rate and systolic blood pressure (P<0.01), diastolic blood pressure (P<0.01) and between urinary 1gG excretion rate and systolic blood pressure (P<0.05) in hypertensive group. As to the 1gG clearance/A1b clearance ratio, significant differences were shown between hypertensives and normal subjects (1.14±1.26, 2.84±3.71, respectively, P<0.001). Furthermore, 1gG clearance/A1b clearance ratio were decreased step by step in Ⅰ,Ⅱ, Ⅲ stages divided according to WHO criteria (1.47±2.06,1.11±1.04, 0.89±0.81, in comparison with the control, P<0.2, P<0.001, P<0.02, respectively). ln conclusion, the change of urinary A1b may be an early sensitive indicator of the vascular consequence of high blood pressure and as a maker, urinary A1b excretion rate seems to be much better than 1gG.

关 键 词：高血压 原发性 尿 免疫球蛋白 测定 

分 类 号：R544.104[医药卫生—心血管疾病]