高血压病患者微量蛋白尿的临床研究

目的探讨高血压病患者肾脏早期损害指标。方法选择高血压病患者138例为观察组,健康体检者92例为正常对照组,采用散射比浊法检测2组的微量白蛋白(ALB)、转铁蛋白(TRF)、α-微球蛋白(α1-MG),并进行分析比较,同时从观察组中抽取56例依从性较好的患者,观察药物治疗前后各项指标的变化。结果正常对照组ALB为(4.04±2.02)mg/L,TRF为(1.07±0.20)mg/L,α1-MG为(5.64±2.06)mg/L,观察组分别为(10.85±5.15)mg/L、(1.72±0.81)mg/L和(13.58±6.07)mg/L,与正常对照组比较,观察组患者ALB显著增高(P<0.05),α1-MG为非常显著增高(P<0.01);观察组中高血压病2~3级与高血压病1级比较,ALB、α1-MG均有非常显著增高(P<0.01);观察组56例患者治疗3~6个月后ALB(9.08mg/L±5.15mg/L)、α1-MG(8.56mg/L±4.87mg/L)与治疗前ALB(12.48mg/L±5.25mg/L)、α1-MG(13.74mg/L±6.38mg/L)比较均有显著降低(P<0.05或P<0.01)。结论α-MG及ALB为高血压病早期肾损害的敏感指标,与高血压分级呈正相关,且能反映高血压的控制状况。

Clinical observation on the microdose proteinuria in patients with hypertension

Objective To investigate the parameters of the early damage of kidney in patients with hypertension.Methods 138 patients with hypertension (observation group)and 92 healthy subjects (control group)were selected in the study.The microalbumin (ALB), tranferrinuria (TRF),α_1-microglobulin (α_1-MG) were detected by nephelometry for both groups.Meanwhile,56 patients with better compliance were selected from observation group,changes of the parameters were observed after treatment.Results The ALB in control group was (4.40±2.02)mg/L,TRF was (1.07±0.20)mg/L,α_1-MG was (5.64±2.06)mg/L,however,the ALB in observation group was (10.85±5.15)mg/L, TRF was (1.72±0.81)mg/L,α_1-MG was (13.58±6.07)mg/L.As compared with those in control group, ALB in observation group increased significantly (P<0.05),α_1-MG increased obviously (P<0.01).As compared with the 1 grade of hypertension,both ALB and α_1-MG in the 2～3 grade of hypertension increased obviously (P<0.01).In 56 patients selected from observation group the ALB was (12.48±5.25)mg/L,α_1-MG was (13.74±6.38)mg/L before treatment,after treatment the ALB (9.08 mg/L±5.15 mg/L) and α_1-MG (8.56 mg/L±4.87 mg/L) decreased evidently (P<0.05 or P<0.01).Conclusion α_1-MG and ALB are the sensitive parameters of the early damage of kidney in patients with hypertension, which are related with the grade of hypertension,and can reflect the control state of hypertension.