初诊高血压患者尿微量白蛋白相关因素分析

目的:研究初诊高血压患者尿微量白蛋白(MAU)与相关因素的关系。方法:选择年龄在35~64岁的初诊高血压患者472例,所有患者从未服用过降压药。根据尿白蛋白/尿肌酐比值(ACR)将患者分为MAU阳性组(ACR≥30mg/g)和阴性组(ACR30mg/g),其分别为198例和274例。观察并比较两组患者生化指标、24h动态血压、超声心动和颈动脉超声等情况,然后分析MAU与相关因素的关系。结果:①MAU阳性组的诊室、24h、白昼、夜间SBP及DBP均高于对照组。②Logistic回归分析表明年龄、尿酸、诊室SBP及白昼DBP是初诊高血压患者发生MAU的危险因素,夜间血压下降率则是MAU的保护因素。③MAU阳性组左心室肥厚和颈动脉硬化检出率均明显高于MAU阴性组。④随着年龄的增加,MAU的发生率呈递增趋势。结论:年龄、尿酸、诊室SBP及白昼DBP和夜间血压下降率减弱与初诊高血压患者MAU发生密切相关。

Association between microalbuminuria and relevant factors in intial hypertension patients

Objective：To investigate the relationship of the microalbuminuria（MAU） and relevant factors.Methods：We select 472 cases of hypertension patients who never take blood pressure medication.According to the urinary albumin/creatinine ratio （ACR） urine divided the patients into positive-MAU group （ACR ≥ 30 mg/g） and negative-MAU group （ACR ＜ 30 mg/g）,two groups of cases of 198 cases and 274 cases respectively.Two groups of patients were measured and compared biochemical indices,24 hour ambulatory blood pressure monitoring,cardiac ultrasound and carotid ultrasound,and so on and so forth.Then we analyze the relationship of the MAU and various parameters of blood pressure and other target organ damage.Results：The clinic,24h,daytime,nighttime systolic blood pressure and diastolic blood pressure of the positive-MAU group were higher than the control group.Microalbuminuria by factors related to Logistic regression analysis showed that age,uric acid,clinic systolic blood pressure and daytime diastolic blood pressure is a risk factor for MAU （β5 ＞ 0,OR ＞ 1）,circadian rhythm is the MAU protective factors （β ＜ 0,OR ＜ 1）.Left ventricular hypertrophy and carotid arteriosclerosis detection rate of the positive-MAU group were significantly higher than that of MAU negative group.With the increase of age,the incidence of urine trace albumin is increasing.Conclusion：Age,uric acid,clinic systolic blood pressure,diastolic blood pressure day and night blood pressure decrease rate decreasing can increase the MAU of the initial hypertension patients.