中年原发性高血压患者血压变异性与高血压早期肾损伤的关系

目的探讨中年原发性高血压患者随诊期间血压变异性与早期肾损伤的关系。方法通过检测59例中年I-Ⅱ级的原发性高血压患者的尿微量白蛋白（mAlb）和尿N-乙酰-p—D氨基葡萄糖苷酶（NAG），将其分为早期肾损伤组（尿mAlb和／或尿NAG阳性，19例）和无肾损伤组（尿mAlb和尿NAG阴性，40例）。回顾性分析其过去24个月间8次随诊时血压值，用随诊期间血压变异标准差（SD）和血压变异系数（CV）评价2组患者随诊期间血压变异性的差异。结果早期肾损伤组和无肾损伤组患者尿mAlb分别为（34±14）、（14±3）mg／24h，尿NAG分别为（29±15）、（10±4）U／L，组间比较差异均有统计学意义（均P〈0．01）。早期肾损伤组随诊期间SBP。SD、SBP—CV明显高于无肾损伤组[SBP—SD：（10．1±2．2）mm Hg（1mm Hg=0．133kPa）比（5．4±1．9）mmHg；SBP—CV：（7．1±1．8）mmHg比（3．8±1．4）／mm Hg，均P〈0．01]。结论中年原发性高血压患者随诊期间SBP—BPV与其早期肾损伤密切相关，可能预测早期高血压肾病的发生。

Relation between visit-to-visit blood pressure variability and early kidney injury in middle-aged primary hypertension patients

Objective To evaluate the relation between visit-to-visit blood pressure variability and early kidney injury in middle-aged primary hypertension patients. Methods All 59 cases initially diagnosed of stage I and II primary hypertension were divided into kidney injury group （ 19 cases ） and non-kidney injury group （ 40 cases ） according to the urinary analysis of microalbumin （mAlb） and N-aeetyl-D-glucosaminidase（NAG）. The data of visit- to-visit blood pressure in past 24 months were retrospectively analyzed. Visit-to-visit variability of blood pressure in two groups was defined as the standard deviation （SD） or coefficient of variation （CV, SD/mean）. Results The levels of mAlb in kidney injury group and non-kidney injury group were （ 34 ±14 ） and （ 14 ± 3 ） mg/24 h ; the NAG was （29±15） and （10 ± 4 ）U/L. There were significant differences （all P 〈 0.01 ）. SD and CV of visit-to-visit systolic blood pressure （SBP） in kidney injury group were significantly higher than those in non-kidney injury group [SBP-SD：（10.1 ±2.2）vs（5.4 ± 1.9）mm Hg;SBP-CV： （7. 1± 1.8） vs（3.8 ± 1.4） mm Hg, all P 〈0. 01]. Conclusions Visit-to-visit variability of SBP is closely related with hypertensive kidney injury in middle-aged essential hypertension patients and may have a similar predictive value for early stage hypertensive nephropathy.