老年高血压患者血压变异性与微量白蛋白尿的相关性研究

Relationship between blood pressure variability and microalbuminuria in elderly patients with hypertension

目的探讨老年原发性高血压(EH)患者血压变异性(BPV)与微量白蛋白尿(MAU)水平的相关性。方法选择61例老年EH患者作为EH组,另选择24例血压正常,年龄≥65岁的老年人作为对照组。进行24 h动态血压监测,比较2组24 h、昼间、夜间收缩压和舒张压的水平,以标准差代表BPV的值。检测MAU作为早期肾功能损害的指标,研究BPV与MAU的相关性。根据24 h收缩压变异性(24hSBPV)的第50百分位数分为低BPV组和高BPV组,比较2组的危险因素。结果与对照组比较,EH组24hSBPV、24 h舒张压变异性(24hDBPV)、昼间收缩变异性(dSBPV)明显增大(P<0.01)。双变量相关分析显示EH组的24hSBPV、24hDBPV、夜间收缩压变异性(nSBPV)、夜间舒张压变异性(nDBPV)与MAU呈正相关(r=0.264~0.492,P<0.05)。高24hSBPV组MAU和年龄较低24hSBPV组明显增高(P<0.05)。结论老年原发性高血压患者24hSBPV、24hDBPV、nSBPV、nDBPV与MAU显著相关,降低BPV对预防早期肾功能损害有益。

Objective To explore the relationship between blood pressure variability(BPV) and microalbuminuria(MAU) in elderly patients with primary hypertension.Methods A total of 61 cases initially diagnosed of stageⅠor Ⅱelderly primary hypertension were enrolled as EH group.Another 24 healthy subjects over 65 years old were chosen as control group.The 24 h ambulatory blood pressure was measured.Mean value and standard deviation(SD) of 24 h,day systolic blood pressure(SBP) and diastolic blood pressure(DBP) were compared between the two groups.The level of microalbuminuria(MAU) was regarded as an indicator for early renal injury.Relationship between BPV and MAU were analyzedd.The EH group was further divided into high BPV group(n=29) and low BPV group(n=32) according to the 50th SD percentile of the 24 h SBP variability,and the risk factors were compared between the two groups.Results The 24 h SBP and DBP variability and the day SBP variability were significantly higher in EH group than those in control group(P<0.01).Bivariate correlative analysis showed that the night,24 h SBP and DBP in EH group were positively correlated with MAU(r = 0.264-0.492,P<0.05).The age and the level of MAU were significantly higher in high BPV group than those in low BPV group(P<0.05) Conclusions Variabilities of the night,24 h SBP and DBP is significantly related with MAU in the elderly patients with primary hypertension.It is helpful for prevention of early renal injury to reduce the level of BPV.