非糖尿病老年高血压人群动态血压与尿微量白蛋白关系探讨

目的探讨非糖尿病老年高血压人群24h动态血压和尿微量白蛋白的关系。方法住院老年高血压患者100例，排除糖尿病，按照尿微量自蛋白（MAU）水平分为MAU〈30mg／24h组和MAU／〉30mg／24h组，观察两组之间动态血压、血肌酐水平等情况。结果MAU／〉30mg／24h组血肌酐水平、夜间收缩压、24h平均血压和夜间平均血压均高于MAU〈30mg／24h组，差异有统计学意义（P〈0．05或P〈0．01）。多元逐步logistic同归分析显示，血肌酐和夜间平均血压是高尿微量白蛋白的独立预测因子。结论对非糖尿病的老年高血压人群，动态血压监测尤其是夜间血压变化对高血压所致肾损害的严重程嚏有预测价值。

Relationship between ambulatory blood pressure and urine microalbnmin level in the elderly with non-diabetic hypertension

Objective To investigate the relationship between 24-hour ambulatory blood pressure and urine microalbumin(UMA)level in the elderly with non-diabetic essential hypertension.Methods One hundred elderly cases with essential hypertension were selected from the Department of Geriatrics,the Sixth People's Hospital,Shanghai and divided into two groups,one with UMA less than 30 mg/24h,and the other with UMA equal to or greater than 30 mg/24h.Ambulatory blood pmssure,serum level of creatinine (sCr),UMA and other characteristics were measured for all the subjects studied and compared to find possible relationship between blood pressure and UMA.Results Level of sCr,diastolic blood pressure at night (nDBP),24-hour average blood pressure,average blood pressure at night were all significantly higher in the group with UMA equal to or greater than 30 mg/24h than that with UMA less than 30 mg/24h(P<0.05 or P<0.01). Multivariate logistic regression analysis indieated that both sCr and nDBP were indispensable predictors for high microalbuminuria in patients with essential hypertension.Conclusions Ambulatory blood pressure monitoring,especially blood pressure variation at night,has more important predictive value for severity of renal damage caused by hypertension in the elderly with non-diIlbetic essential hypertension.