白蛋白尿与高血压患者血压水平的关系

目的 研究我国不同区域高血压患者白蛋白尿与血压水平及体质量指数（BMI）的关系。 方法 在我国5个城市随机抽取5021例明确诊断为高血压的非糖尿病患者，进行两次随机点测尿中的白蛋白/肌酐比值，将尿蛋白的检出率与不同血压水平及BMI进行统计分析。 结果 （1）高血压患者白蛋白尿的检出率，在< 60岁与≥60岁组间差异无统计学意义；高血压病程越长，其检出率越高（P < 0.05）。（2）白蛋白尿检出率与血压水平相关,血压越高，尿蛋白量越高。正常血压、正常高值以及Ⅰ、Ⅱ、Ⅲ级高血压的白蛋白尿检出率分别为26.3%、27.3%、28.7%、31.5%和40.3%。（3）高血压患者血压控制达标（<140/90 mm Hg）与控制不良（≥140/90 mm Hg）的蛋白尿排出率差异有统计学意义（27.1% 比 30.2%，P < 0.05）。（4）同等血压水平时，肥胖高血压患者的白蛋白尿检出率高于体质量正常者，但差异无统计学意义。（5）有蛋白尿的高血压患者发生更多的心脑肾血管事件。 结论 我国5021例高血压患者中，其白蛋白尿的发生率为28.8%，其中微量白蛋白尿的发生率为18.6%，临床白蛋白尿的发生率为10.2%。血压控制不良是蛋白尿发生的重要因素。

Association between albuminuria and blood pressure level in patients with essential hypertension

Objective To investigate the association between albuminuria incidence and blood pressure (BP) level or body weight index (BMI) in patients with essential hypertension from five regions in China. Methods A total of 5021 non-diabetic patients with clearly diagnosed essential hypertension were enrolled in our study. The participants came from five cities in China.Urinary albumin/creatinine ratio was measured in these patients for two times. The associations of albuminuria with BP level and BMI were analyzed. Results (1)There was no significant difference of albuminuria incidence between ＜60-year-old and ≥60-year-old patients. The longer the hypertension exited, the higher the albuminuria incidence was. (2) The albuminuria incidence was associated with blood pressure level significantly. The urinary protein excretion increased with the level of blood pressure. The albuminuria incidences in patients with normal BP, upper range of normal BP, Ⅰ , Ⅱ or Ⅲ stage hypertension were 26.3%, 27.3%, 28.7%, 31.5% and 40.3% respectively. (3) The albuminuria incidence was significantly different in patients with uncontrolled BP (≥ 140/90 mm Hg) compared with those with well controlled BP (＜ 140/90 mm Hg) (27.1% vs 30.2%, P＜0.05 ). (4) The albuminuria incidence was higher in obese patients compared with those with normal BMI at same BP level, but the difference was not statistically significant. (5) Patients with albuminuria had more cardiocerebral or renal events as compared to those without proteinuria. Conclusions The albuminuria incidence of non-diabetic hypertensive patients from 5 cities in China is 28.8%, of which the microalbuminuria incidence is 18.6% and the clinical albuminuria incidence is 10.2%. Uncontrolled BP is an important risk factor of proteinuria.