α_1-微球蛋白与原发性高血压早期肾损害

α_1-Microglobulin and early renal damgfe in patients with essential hypertension

测定了70例原发性高血压（EH）患者和30例年龄性别相近的正常人尿液中的白蛋白（Alb）、α1－微球蛋白（α1M）、N－乙酸－β－D－氨基葡萄糖苷酶（NAG）活性．发现EH患者尿Alb、α1M、NAG均显著高于正常对照，尿a1M随分期显著增高（P＜0.01），尿Alb在Ⅰ、Ⅱ期组均显著高于正常对照（P＜0．01），尿NAG于Ⅱ期组明显高于正常（P＜0．05）；尿Alb与血压显著正相关，α1M与Alb正相关（γ=0．625、P＜0．01）．结果表明：①EH患者的尿Alb排泄增高并与血压密切有关，早期（Ⅰ期）即有肾小球损害；②尿a1M能反映EH患者肾小管受损的状况，尿a1M与Alb一样加升高可作为早期肾损害的信号．

70 patients with easential hypertension (EH) without proteinuria, 49 were in stage I of the WHO and 21 in stage Ⅱ. Urinary albumin(UA1b),α1-Microglobulin (Ua1M ), N - acetyl - β -Dglucosaminidase activity(UNAG),creatinine(Ucr)and serum creatinine(Scr),blood urea nitrogen (BUN)were measured in all patients and normal control with the same age,sex. UA1b,Ua1M,UNAG were expressed as per mmol Ucr. Results:Scr and BUN were no significant difference in EH patients compared with normal control. UA1b, Uo1M, UNAG were significantly higher than that of normal (P<0. 01,P<0. 01,P<0. 05,respectively). In stage I patients, UA1b, Uα1M increased significantly (P<0. 01), but UNAG was no significant difference. In stage Ⅲ patients. UAu. Ua1M.UNAG were also significantly higher than that of cormal control(P<0.01, P<0. 01, P<0. 05,respectively),Uα1M in stage Ⅲ was markedly higher than that of stage I (P<0.01). relation analysis found: there were positive correlation between UA1b and blood pressure, and Uα1M(γ=0. 625.P<0. 01), and UNAG(γ= 0. 221, P= 0. 053). Uα1M and UNAG (γ=0.287, P<0.02) in EH patients.However, a better corelation was found between UA1k and Ua1M both by logarithmic transform(γ=0.681). In 70 EH patients exceeded upper limit of the 80th centile for normal subjects: UNAG was 19(27%),UA1b 35(50%),Ua1M 43(61%),the difference of positivity rate in Ua1M and UA1b was approximately significance level (pair x2=3. 76, P=0.054). these data suggest that ①there is correlation between blood preasure and UA1k in EH-patients and renal dysfunction, even if in early patients (stage I);①Ua1M, when increases, is as a good indicator of early renal damage as UA1b,Ua1M seems likely to be a more sensitive marker③UA1b, Ua1M, UNAG may serve as observal indicators for antihypertensive drugs to improve renal function of not.