高血压病对心肾的损害程度及其相关性  

The seriousness and correlation in impaired heart and kidney in hypertension patients

作　　者：程志坚[1] 邓学东[2] 沈延政[2] 黄敏[2] 裘建明[3] 何巧平[1] 严禹[2] 孙勤[2] 

机构地区：[1]南京医科大学附属苏州第四人民医院心内科,江苏苏州215001 [2]南京医科大学附属苏州第四人民医院苏州超声医学研究室,江苏苏州215001 [3]南京医科大学附属苏州第四人民医院同位素室,江苏苏州215001

出　　处：《心脏杂志》2003年第5期434-436,共3页Chinese Heart Journal

摘　　要：目的 :探讨高血压病心肾损害严重程度及其相关性。方法 :对 85例高血压病患者和 2 0例健康者超声心动图 ,肾功能 ,肾动脉血流动力学 ,血尿 β2 微球蛋白 (β2 MG) ,体重指数 (BMI) ,等结果进行对比。结果 :1高血压 期心脏以向心性肥厚为主 , 期以离心性肥厚为主 ,室间隔增厚均大于左室后壁 ,左室质量指数 (L VMI)进行性增大。 2高血压病 - 期肾功能进行性受损 ,血液尿素氮 (BUN)、肌酐 (Cr)增高 ,肌酐清除率 (Ccr)降低 ,血尿 β2 - MG增加。3肾动脉最大血流速度 (Vmax) ,血管阻力指数 (RI)增高伴随肾功能恶化。 4高血压病晚期 BMI减少 .5回归分析显示 :L VMI/K(K值 :男 134,女 110 )与 Ccr呈负相关 ,Ccr与 RI呈负相关 ,但 L VMI/K与 RI相关性不显著。结论 :高血压病对心脏 ,肾脏同时产生损害 ,损害程度具有相关性。AIM:To study the seriousness and correlation in impaired heart and kidney in hypertensive patients. METHODS:The echocardiographies,renal arterial hemodynamics,renal function,β 2 microglobulin (β 2 MG)in blood and urine,body mass index (BMI) of 85 hypertensive patients and the renal arterial hemodynamics of 20 healthy men were analysed. RESULTS:①Most of the patients with Ⅱ phase hypertension suffered concentric hypertrophy. While most of patients with Ⅲ phase hypertension had eccentric hypertrophy.The septum was thicker than the posterior wall in both the Ⅱ and Ⅲ phase hypertensive patients. Left ventricular mass index(LVMI) increased progressively in Ⅰ,Ⅱand Ⅲ phase hypertensive patients.②Renal function was damaged progressively, blood urea nitrogen(BUN) and creatinine clearance (Ccr) declined, and β 2 MG in blood and urine rose in all the above hypertensive patients. ③V max and vascular resistance index(RI) in renal artieral hemodynamics increased progressly with the worsening of renal function.④Body mass index(BMI) decreased in the late hypertensive patients.⑤Linear regression analysis showed that LVMI/K( K value:134 in men,110 in women) was negatively correlated with Ccr,which was negatively correlated with RI, but LVMI/K did not correlate significantly with RI. CONCLUSION:Hypertension brought about impaired heart and kidney at the same time. There was a correlation between the impaired heart and kidney.

关 键 词：高血压 心肾损害 相关性 

分 类 号：R541.3[医药卫生—心血管疾病]