原发性高血压成人尿钠排泄量与颈动脉硬化及血基质金属蛋白酶9的关系

目的探讨原发性高血压成人尿钠排泄量与颈动脉粥样硬化及血基质金属蛋白酶9的关系。方法选择成人原发性高血压117例，通过24h尿钠排泄量测定钠盐摄入量，将人选人群分为低盐组（n=30），低中盐组（n=28），中高盐组（n=27），高盐组（n=32）。测量颈动脉内膜中层厚度（IMT）值，采用酶联免疫吸附法检测血基质金属蛋白酶9（MMP-9）水平。用多元逐步线性回归分析法分析24h尿钠排泄量、年龄、性别、血压、脉率、BMI、胆固醇、三酰甘油、血糖对IMT值的影响。对MMP-9与尿钠排泄量及IMT值进行相关性分析。结果4组患者的收缩压、舒张压、IMT值，随24h尿钠排泄量的增加而增高（P〈0．05）。多元逐步线性回归分析结果显示24h尿钠排泄量增高是IMT增加的独立危险因素（回归系数0．021，P〈0．05）。MMP-9与尿钠排泄量存在正相关性（r=0．33，P〈0．05）。结论高血压患者高钠饮食可能有独立于血压之外的影响，促进动脉粥样硬化的形成。MMP。9的活性可能发挥了作用。

Correlation between urinary sodium excretion and carotid atherosclerosis and serum matrix metalloproteinase-9 in adults with essential hypertension

Objective To investigate the correlation between urinary sodium excretion and carotid atherosclerosis and serum matrix metalloproteinase- 9 （MMP） in adults with essential hypertension. Methods A total of 117 adults with essential hypertension were enrolled in the study, and based on their 24-hour urinary sodium excretion, divided into low （n=30）, moderate （n=30）, moderate-to-high （n=30） and high sodium intake group （n=30）, respectively. Intimal medium thickness （IMT） was examined by color Doppler ultrasonography, and serum MMP- 9 was determined by enzyme-linked immunosorbent assay. Stepwise regression analysis was employed to evaluate the effects of 24-hour urinary sodium excretion, age, sex, blood pressure, pulse rate, body mass index, cholesterol, triglyceride and blood glucose on the level of IMT. The correlation between MMP-9 and urinary sodium excretion was also analyzed. Results Increased level of 24-hour urinary sodium excretion was associated with augmented systolic and diastolic blood pressure and IMT （all P〈0.05）. The 24-hour urinary sodium excretion was, as suggested by stepwise regression analysis, the independent risk factor of increased IMT （regression coefficient 0.021, P〈0.05）. MMP-9 was positively correlated with urinary sodium excretion （r=0.33, P〈0.05）. Conclusion High sodium intake, may lead to increased incidence of carotid atherosclerosis independently of the blood pressure, and MMP-9 may play a role in the development.