动态动脉硬化指数与老年原发性高血压病患者左心室肥厚及尿微量白蛋白的关系研究

目的:探讨老年高血压病患者动脉硬化指数与左心室肥大及早期肾脏损害征象之间的关系。方法:随机检测137例高血压病患者的动态动脉硬化指数(AASI)、24 h动态血压、心脏重量指数(LVMI)、肌酐、尿微量白蛋白(MAU)及其他血脂等血生化指标。按照患者的AASI分为两组:AASI低水平组(AASI≤0.51)76例,AASI高水平组(AASI>0.51)61例。比较两组各参数指标的差别;并对各参数指标与AASI进行线性相关性分析和多因素Logistic回归分析。结果:与AASI低水平组相比,AASI高水平组尿微量白蛋白量增高(P=0.007)。线性回归结果显示,AASI增加可升高与尿微量白蛋白(β=0.761,P=0.001)及心脏质量指数(β=0.466,P=0.004)。校正可能的混杂因素后,AASI升高可增加左心室肥大(OR=1.96,95%CI=1.67~3.98,P=0.003)及早期肾脏功能损害(OR=2.28,95%CI=1.76~4.44,P=0.008)的患病风险。结论:AASI是老年高血压患者左心室肥大及早期肾损害的独立危险因素。

Association study between ambulatory arterial stiffness index and left ven-tricular hypertrophy,as well as early signs of renal damage in elder pa-tients with primary hypertension

Objective:To investigate the relationship between ambulatory arterial stiffness index (AASI)derived from blood pressure monitoring and left ventricular hypertrophy,as well as early signs of renal damage in elder patients with primary hypertension. Methods:137 primary hypertensive outpatients were divided into two groups according to their AASI values:normal AASI group (AASI≤0.5 1 ,n =76)and high AASI group (AASI >0.5 1 ,n =61 ).The urinary micro albumin uria,glomerular filt ration rates (GFR),left ventricular mass index were measured and compared.The linear regression and multiple Logistic regressions were carried between AASI and micro albumin uria,left ventricular mass index.Results:Compared with those in the normal AASI group,the patient s in high AASI group showed a higher level of urinary microalbuminuria (P =0.007)and left ventricular mass index (P <0.001 ).As AASI increas-ing,the level of urinary microalbumin uria(β=0.761 ,P =0.001 )and left ventricular mass index were also increasing(β=0.466,P =0.004).After adjusting the potentially confounding variables,the odd ratio (OR)of AASI to left ventricular hypertrophy was 1.96 (95%CI =1.67-3.98,P =0.003),to renal damage was 2.28 (95%CI =1.76-4.44,P =0.008).Conclusion:AASI is an independ-ent risk factor for left ventricular hypertrophy and early signs of renal damage in elder patients with primary hypertension.