老年高血压患者的动态脉压与尿微量白蛋白的相关性研究

目的探讨动态脉压与尿微量白蛋白(mAlb)的关系,以期为动态血压监测(ABPM)应用于早期诊断和评价高血压性肾损害提供科学依据。方法将老年高血压患者(≥75岁)210例按24h动态脉压(24h PP)≤40mmHg、41～55mm Hg、56～70mm Hg、>70mmHg分为Ⅰ、Ⅱ、Ⅲ、Ⅳ组(50例、55例、55例、50例)。测量各组24h PP、尿mAlb,比较各组的尿mAlb检测值及其阳性率。结果Ⅰ组与Ⅱ组尿mAlb及微量蛋白尿阳性率差异无统计学意义(P>0.05);Ⅱ组、Ⅲ组与Ⅳ组随24h PP的增高,微量蛋白尿阳性率及尿mAlb均依次明显增高,各组间比较差异有统计学意义(P<0.05)。结论在高血压患者的治疗中,不仅要控制收缩压和舒张压在理想的范围,而且还能降低动态脉压。

Correlational study on ambulatory pulse pressure and urine mAlb in elderly patient with hypertension

Objective To discuss the relationship between ambulatory pulse pressure and urine mAlb for the evaluation of early renal impairment in essential hypertension patients.Methods 210 cases elderly patients with hypertension（≥75 years） were divided into Ⅰ group[24h ambulatory pulse pressure（24h PP）≤40mm Hg,50 cases],Ⅱ group（24h PP 41~55mm Hg,55 cases）,Ⅲ group（24h PP 56~70mm Hg,55 cases） and Ⅳ group（24h PP70mm Hg,50 cases）.Measured 24h PP,urinary mAlb in each group,compared urine mAlb detection value and the positive rate in each group.Results Urine mAlb and the positive rate were not significantly different between Ⅰ group and Ⅱgroup（P0.05）.Ⅱ Group,Ⅲ group and Ⅳ group with 24h PP increased,the positive rate and urinary mAlb were turn significantly higher,the difference between the groups were statistically significant（P0.05）.Conclusion On the treatment of the elderly patient with hypertension,should not only control systolic pressure and diastolic pressure on the ideal range,but also ruduce the ambulatory pulse pressure.