高血压类型与微量白蛋白尿的相关分析

目的探讨高血压患者脉压与尿微量白蛋白(microalbuminuria)排泄量的关系。方法选取243例原发性高血压患者,按照高血压类型分为杓型(198例)和非杓型(45)两组。比较两组间性别、年龄、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平、体重指数、蛋白尿的发生率及24h尿蛋白排泄量。结果非杓型高血压组尿蛋白阳性率为41.3%、24h尿白蛋白排泄量为(234.6±41.4)mg,均明显高于杓型高血压组23%,(146±35)mg。收缩压、脉压与24h尿蛋白量呈正相关,其相关系数r分别为0.478(p<0.05)、0.637(p<0.05);尤其在非杓型高血压中,脉压与24h尿蛋白量排泄量相关系数r=0.81(p<0.05)远高于杓型(r=0.58,p<0.05)。结论非杓型高血压较杓型高血压引起的肾损害害明显早于和严重于杓型高血压;抗高血压治疗亦应注意合理地控制夜间血压。

STUDY ABOUT THE RELEVANCE BETWEEN THE TYPE OF BLOOD PRESSURE AND MICROALBUMINURIA IN HYPERTENSIVE PATIENTS

Objective To investigate the relevance between the type of blood pressure (BP) and urinary microprotion in hypertensive patients.Methods All the patients were divided into two groups by the type of blood pressure:non-dipping pattern(45 subjects,18.5%) and dipping pattern(198 subjects,81.5%).Results Patients with microalbuminuria, the level of microalbuminuria, lipid, BMI were detected by groups.Patients with microalbuminuria and urinary albumin excretion(UAE) were significantly higher in non-dippers than in dippers (41.3 versus 23%, p<0.01;234.6±41.4mg versus 146±35mg, p<0.05, respectively).UAE was correlated with PP(pulse pressure),SBP (r=0.637,0.478,respectively,for both, p<0.05),between non-dipping pattern and dipping pattern (r=0.81,0.58, respectively).Conclusion This study suggests that the non-dipping pattern of ambulatory BP can be associated with a faster and more serious progression of renal insufficiency than dipping pattern.A proper nocturnal BP control is an additional aim of antihypertensive therapy.