炎性因素对A型行为高血压患者早期肾脏损害的影响

The Effect of Inflammation on Early Renal Damage in Patients with Hypertension of Type A Behavioral

目的 探讨炎症介质对A型行为高血压患者早期肾脏损害的影响。方法 研究对象90例分为A型行为高血压组（A组，n=30）、非A型行为高血压组（B组，n=30）及健康对照组（C组，n=30），检测、比较各组间血CRP、IL-1β、IL-6、TNF-α水平及尿β2微球蛋白、微量白蛋白水平并作相关分析。结果 A组血CRP、IL-1β、IL-6、TNF-α水平及尿β2微球蛋白、微量白蛋白水平明显高于B组（P均〈0．05）；B组血CRP、IL-1β、IL-6、TNF-α水平及尿微量白蛋白水平明显高于C组（P均〈0．05）。经多元线性回归分析，尿β2微球蛋白与血CRP、IL-1β、IL-6、TNF-α水平直线相关（P〈0．05～0．01）；尿微量白蛋白与血IL-1β、IL6水平直线相关（P＜0．05～0．001）。而且血浆CRP、IL-1β、IL-6和TNF-α含量亦互相呈正相关（P均〈0．001）。结论 A型行为高血压患者早期肾脏损害较非A型行为高血压者严重，A型行为是高血压病肾脏损害的独立危险因素；炎症介质可能在A型行为高血压患者早期肾脏损害中起重要作用。

Objective To investigate the effect of inflammatory mediators on early renal damage in patients hypertension of type A behavioral. Methods The subjects were divided into three groups： type A behavioral hypertension group（group A, n= 30）, non-type A behavioral hypertension group（group B, n =30）and healthy contrast group（group C, n=30）. The plasma C-reactlve protein（CRP）, interleukin 1 （IL-1β）, interleukin-6 （ IL-6 ）, tumor necrosis factor-α （ TNF-α ） and urinary β2-microglobulin （ β2-MG）, microalbumin were determined in three groups. Results The levels of plasma CRP, IL-1β, IL-6, TNF-α and urinary β2-MG, mieroalbumin were higher in group A than those in group B（P〈0. 05）, while levels of plasma CRP, IL-1β, IL-6, TNF-α and urinary microalbumin were higher in group B than those in group C （P〈0. 05）. Multiple variables regression analysis revealed that the plasma of CRP, IL-1β, IL-6 and TNF-α were lineally related to urinary β2 MG （P〈0. 05-0.01 ）while the plasma of IL-1β, IL-6 were relat ed to urinary microalbumin（P〈0.05-0. 001 ）. In addition, the plasma concentration of CRP, IL-1β, IL- 6 and TNF-α were positive related each othcr（P〈0. 001）. Conclusion Early renal damage in patients with type A behavioral hypertension is more serious than that in patients with non-type A behavioral hypertension. Type A behavior is an independent risk factor for renal damage in hypertension. Inflammatory mediators perhaps plays role in early renal damage in patients with type A behavioral hypertension.