高血压病早期肾脏损害相关指标的研究

目的探讨原发性高血压（EH）患者脉压与尿微量白蛋白（UmAlb）早期肾功能损害的相关性。方法对180例原发性高血压患者进行24小时动态血压监测，记录脉压（PP）值，按脉压（〉60mmHg与≤60mmHg，1mmHg；0．133kPa）分组，观察两组血尿素氮（BUN）、肌酐（Cr）、尿酸（UA）及尿微量白蛋白（UmAlb）变化及其与脉压值的相关性。结果脉压〉60mmHg组UA、UmAlb明显高于脉压≤60mmHg组（P〈0．01）；偏相关分析显示，UmAlb与收缩压（r：0．315，P〈0．05）、脉压（r=0．408，P〈0．01）呈正相关。结论脉压值能够很好地反映原发性高血压患者肾脏早期损害，是肾脏早期损害的重要危险因子；脉压大小与尿微量白蛋白严重程度密切相关，定期检测尿微量白蛋白对发现原发性高血压早期肾脏损害有重要的诊断价值。

Related Indexes to Early Renal Injury in Patients with Essential Hypertension

Objective To investigate the relationship between dynamic pulse pressure（PP） and early renal damage（ Urine microalbum, UmAlb） in patients with essential hypertension （EH）. Methods The 24 hours＇ ambulatory blood pressure （24 h ABP） was monitored in 180 patients with EH. The patients were divided into two groups according to the levels of ambulatory PP （A PP, ≥60 mm Hg or ≤60 mm Hg）. The association of the blood BUN, Cr, UA and urine microalbum （UmAlb） with PP was analyzed. Results UmAlb and UA were significantly higher in PP ≥ 60 mmHg group than that in PP ≤ 60 mm Hg group （ P 〈 0.01 ）. After adjustment for age, weight, body mass index （BMI） and diastolic blood pressure （DBP） ,there was a positive relationship between UmAlb and SBP（ r = 0.315, P 〈 0.05 ） and PP （ r = 0. 408, P 〈 0, 01 ）. Conclusion There is a correlation between SBP, PP and UmAlb. PP can sensitively predict the early renal impairment in EH patients, and is the important risk factor of early renal injury. The pulse pressure value is closely correlated with severity of UmAlb in EH patients. Regular tests of UmAlb are of great significance in diagnosing early renal injury in EH patients.