高血压盐敏感者肾脏锂清除率,肾血流动力学和尿微白蛋白排泄

目的探讨盐敏感者肾脏损害与肾脏钠代谢及肾血流动力学的关系，以期对盐敏感者肾损害的防治提供理论依据。方法６０例原发性高血压患者采用急性静脉盐水负荷法确定盐敏感性，并观察肾脏锂清除率，肾血流动力学改变及２４小时尿微白蛋白排泄量。结果与盐不敏感性高血压患者相比，盐敏感者肾脏锂清除率和锂排泄分数低，近端肾小管钠的重吸收率高于盐不敏感者；盐敏感者双肾血流量减低、滤过分数及肾血管阻力均高于盐不敏感者（Ｐ＜０．０１），２４小时尿微白蛋白排泄量高于盐不敏感者。结论盐敏感者存在盐负荷后肾血流动力学适应性调节异常及近端肾小管钠转运障碍，其肾功能损害可能较盐不敏感者出现早。

Renal Lithium Clearance,Renal Hemodynamics,Urinary Microalbumin Execretion in Salt Sensitive Hypertention

Aim To ivestigate the renal function in salt sensitive hypertension. Methods Salt sensitivity(SS) were determined in 60 cases mild or moderate hypertensive patients by acute salt load and deducation as suggested by Weinberger. We observed renal lithium clearance,renal hemodynamics and 24 hours urine microalbumine execretion. Results Compared with non SS(NSS), renal lithium clearance decreased(P<001),Na reabsorption rate in the proximal tubules were increased in SS patients(P<001);SS patients had lower renal blood flow(P<001),filtration fraction. Renal vascular resistance is higher than that NSS patients(P<001). These results indicate that SS patients may retain more sodium than NSS and the renal injury may develop early in SS patients.