原发性高血压患者微量白蛋白尿与血压及左室重塑的关系

目的探讨原发性高血压(EH)患者微量白蛋白尿(MCA)与血压及左室重塑的关系.方法 84名EH患者按24h尿微量白蛋白值分为微量白蛋白尿组(MCA组)和正常白蛋白尿组(NMCA组),进行动态血压、心脏超声检测,比较两组动态血压值、左室重量指数(LVMI)及左室重塑的特点.结果 MCA组平均收缩压、平均舒张压、脉压、平均动脉压均高于NMCA组(均P＜0.01);MCA组LVMI、左室肥厚与向心性肥厚的发生率均高于NMCA组(均P＜0.01),正常构型率低于NMCA组(P=0.01).LVMI与尿微量白蛋白值、平均收缩压、平均舒张压均呈显著的正相关(均P＜0.05).结论合并有MCA的EH患者血压较高,LVMI较大,左室肥厚与向心性肥厚的发生率较高.MCA与血压及左室重塑密切相关.

Microalbuminuria and Left Ventricular Remodeling In Patients with Essential Hypertension

Objective To explore the relationship between microalbuminuria(MCA) and left ventricular (LV) remodeling in patients with essential hypertension (EH). Methods Consecutive 84 inpatients with essential hypertensive were divided into two groups according to 24-hours albumin excretion:the group of patients with MCA and the group of patients with normoalbuminuria(NMCA). Ambulatory 24-hours blood pressure monitoring was performed and gender-specific values for LV mass index (LVMI) were measured with echocardiography.Results Subjects with MCA had higher systolic pressure, diastolic pressure, pulse pressure and average blood pressure, significantly increased LVMI,higher incidence of hypertrophy and concentric remodelling of left ventricular than those with NMCA (P<0.01).Multivariate analysis revealed that LVMI was positively correlated with MCA value (P<0.05) and ambulatory blood pressure (P<0.01). Conclusion MCA was positively related to average blood pressure and LV remodeling.