对称动态动脉硬化指数对原发性高血压患者早期肾功能损害的预测

目的：探讨对称动态动脉硬化指数（S-AASI）对原发性高血压患者早期肾功能损害的预测价值。方法：选择原发性高血压患者300例,测量患者的动态血压参数并计算S-AASI,检测尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）/肌酐（NAG/Cr）,化验血清肌酐并计算Ccr。根据S-AASI的四分位数将受试者分为A、B、C、D 4组。比较4组患者各参数的差别,并行S-AASI与尿NAG/Cr等参数的多元相关回归分析。结果：①4组的年龄随S-AASI水平的增高依次增高（P〈0.05）。A、B组高血压病程差异无统计学意义（P〉0.05）,B、C、D组高血压病程依次延长,各组间比较差异有统计学意义（P〈0.05）。②4组之间的血清肌酐比较差异无统计学意义（P〉0.05）,但4组尿NAG/Cr及微量蛋白尿阳性率均依次增高,而Ccr依次降低,组间比较差异有统计学意义（P〈0.05）。③多元线性回归分析显示S-AASI与尿NAG/Cr（β=0.470,P〈0.001）、Ccr（β=-0.322,P〈0.05）具有相关性。尿NAG/Cr每增加1 IU/g,S-AASI相应增加0.005;Ccr每降低1 ml/（min.1.73 m2）,S-AASI相应增加0.003。结论：S-AASI可作为高血压早期肾功能损害的预测指标。

Symmetric ambulatory arterial stiffness index predicts early renal impairment in patients with essential hypertension

Objective：To investigate the relationship among symmetric ambulatory arterial stiffness index（S-AASI）,urine n-acetyl-β-D-glucosaminidase（NAG） and creatinine clearance rate（Ccr） in patients with essential hypertension.Methods：Three hundred patients with essential hypertension were enrolled.Ambulatory blood pressure monitoring（ABPM） was performed for S-AASI.Microproteinuria was quantified by urine NAG to creatinine ratio（NAG/Cr）.Ccr was calculated with serum creatinine using Cockcroft-Gault formulation.The subjects were divided into four groups according to the S-AASI quartiles for comparison.Multivariate regression analysis was performed to confirm the association between renal impairment（using either NAG/Cr or Ccr） and S-AASI.Results：① S-AASI increased with the age of the patients.No significant difference of the course of the essential hypertension was revealed between group A and B（P〉0.05）.However,significantly prolonged course was observed as S-AASI increased in group B,C and D（P〈0.05）.② Although no significant difference in serum creatinine was recorded among 4 groups,significantly successively increase and reduction were revealed in NAG/Cr and Ccr,respectively,as S-AASI increase in the 4 groups（P〈0.05）.③ Significantly independent correlations were revealed between S-AASI and NAG/Cr（β= 0.470,P〈0.001） and Ccr（β=-0.322,〈P0.05） according to multivariate regression analysis.With NAG/Cr increased by 1 IU/g,S-AASI was raised by 0.005.And with Ccr reduced by 1 ml/（min·1.73 m2）,S-AASI was raised by 0.003.Conclusion：S-AASI is suggested as a predictive index in renal impairment of essential hypertension.