高血压糖尿病患者尿微量白蛋白与动脉弹性之间的关系

目的了解高血压和糖尿病患者尿微量白蛋白与动脉弹性改变之间的关系.方法对入选的200例高血压和（或）糖尿病患者进行晨尿白蛋白/肌酐比值测定,根据结果将入选患者分为尿白蛋白/肌酐比值正常和升高两组.分别应用DO-2020动脉功能测定仪、Complior自动脉搏波速度测定仪测定动脉弹性相关指标：大动脉弹性指数（C1）、小动脉弹性指数（C2）、颈-股动脉脉搏波传导速度（PWVcf）.应用统计学方法进行C1、C2、PWVcf组间差异比较.结果（1）尿白蛋白/肌酐比值升高组C1、C2均明显低于正常组,PWVcf显著高于正常组,差异有统计学意义（P〈0.01）.（2）年龄分层后发现,〈60岁组患者中,尿白蛋白/肌酐比值升高组C1显著低于正常组,PWVcf显著高于正常组,差异有统计学意义（P〈0.01）;≥60岁组中,尿白蛋白/肌酐比值升高组C1、C2明显低于正常组,差异有统计学意义（P〈0.05）.（3）将患者分为单纯高血压、单纯糖尿病、高血压合并糖尿病3组进行分析,结果显示：3组患者中尿白蛋白/肌酐升高组C1、C2均低于正常组,PWVcf均高于正常组,高血压合并糖尿病组差异有统计学意义（P〈0.05）.结论高血压和糖尿病患者尿白蛋白/肌酐比值的升高与其动脉功能有关,尿白蛋白排泄率高的患者存在明显的动脉弹性功能异常.

Association between microalbuminuria and arterial stiffness in hypertensive and diabetic patients

Objective To investigate the relationship between microalbuminuria and arterial compliance in hypertensive and diabetes patients. Methods A total of 200 patients with essential hypertension and/or diabetes were studied. Albumin/creatinine ratio (ACR) was determined. Carotid to femoral Pulse Wave Velocity (PWV), C_1 and C_2 were measured by a Complior Colson device and DO-2020, respectively. Result (1) C_1 and C_2 were lower and PWV higher in high ACR group than in normal ACR group (P<0.01). (2) In patients younger than 60 years, C_1 was lower and PWV higher in high ACR group than that in normal ACR group (P<0.01). In patients older than 60 years, C_1, C_2 were lower in high ACR group than in normal ACR group. Conclusion The results indicated that compliance of large and small vessels in hypertensive and diabetic patients decreased with increaseing ACR.