踝臂指数在高血压肾损害早期诊断中的临床价值

目的观察踝臂指数（ABI）在高血压。肾损害早期诊断中的意义。方法将本院原发性高血压病患者90例根据ABI分为ABI异常组（n=36）和ABI正常组（n=54）。测量ABI的同时测量肾功能早期损害的指标尿微量白蛋白（mALB），应用SPSS13．0统计软件对数据进行统计学分析。结果ABI异常组年龄、血压均较ABI正常组高（P〈0．05）。ABI与mALB呈显著负相关（r=-0．89，P〈0．01）。ABI异常组的mALB阳性率明显高于ABI正常组（P〈0．01），两组间尿标本β2-微球蛋（β2-MG）阳性率及尿N-乙酰-β—D氨基葡萄糖苷酶（NAG）阳性率比较，差异无统计学意义（P〉0．05）。mALB阳性组与mALB阴性组的ABI值差异有统计学意义（t=4．35，P〈0．05）。结论ABI灵敏度高，可较好地及时、早期反映高血压肾损害早期肾小管损害程度，有利于对高血压肾损害的早期诊断、预防及逆转，简单易行，且较病理学检查安全，无创性高，具有一定的临床参考意义。

Clinical application of ankle brachial index in early diagnosis of renal impairment patients with essential hypertension

Objective To observe the siginificance of ankle brachial index （ABI） in early diagnosis of renal damage with essential hypertension.Methods According to ABI,90 patients with essential hypertension were divided into ab- normal ABI group （n=36） and normal ABI group （n=54）.The early renal damage index mALB and ABI was measured at the same time.All data were analysed with the SPSS 13.0 statistical software.Results The age,blood pressure and mALB in abnormal ABI group was higher than that in normal ABI group （P〈0.05）.ABI was negative correlation with mALB （r=-0.89,P〈0.01）.The urinary mALB positive rate of observation group was obviously higher than that of control group （P〈0.01）,there was no significant difference of β2-MG and NAG between the two groups （P〉0.05）.There was sig- nificant difference of the value of ABI between the positive and negative group of microalbuminuria （t=4.35,P〈0.05）. Conclusion The high sensitivity of ABI can better reflect the early hypertensive renal damage.It is benefit for early di- agnosis,prevention and reversal of hypertensive renal damage.ABI is safer than pathology examination and is of certain clinical significance.