老年高血压患者动态脉压及脉压指数与尿白蛋白关系

Correlation between dynamic pulse pressure, pulse pressure index and albuminuria in senile hypertensive patients

目的 探讨老年高血压患者动态收缩压（SBP）、舒张压（DBP）、脉压（PP）和脉压指数（PPI）与尿白蛋白（ALB）的关系，评价PP和PPI在反映高血压患者早期肾损伤方面的价值。方法 用动态血压监测仪测量220例老年高血压患者的PP和PPI，按PPI≤40mmHg（51例）、41～60mmHg（71例）、61～80mmHg（66例）和〉80mmHg（32例）分为4组；按PPI≤0．40（54例）、0．41～0．50（75例）、0．51～0．60（62例）和〉0．60（29例）分为4组。采用免疫比浊法测定研究对象的尿ALB和血脂，比较各组尿ALB的水平。结果 各组间性别比、年龄、血脂异常均无显著性差异，随着PP、PPI的增加，尿ALB水平明显增高（P〈0．05）。经Spearman相关分析，PP和PPI与尿ALB水平的相关系数（r）值（0．416，0．483）大于SBP和DBP与尿ALB的r值（0．325，0．302）。结论 PP和PPI与尿ALB水平密切相关，其在反映高血压患者早期肾损伤的价值优于SBP和DBP。

Objective To investigate the correlation of systolic blood pressure （SBP）, diastolic blood pressure （DBP） , pulse pressure （PP）, pulse pressure index （PPI） with albuminuria （ALB） in senile hypertensive patients and to evaluate the value of PP and PPI in reflecting early renal injury. Methods 220 cases, whose PP and PPI level were measured by the dynamic blood pressure （BP） monitor, conformed to the diagnostic standards for senile hypertension and were divided into 4 groups based on PP level, as PP ≤40 mmHg（51 cases） ,41 -60 mmHg （71 cases） ,61 -80 mmHg（66 cases） and 〉 80 mmHg（32 cases）. These cases were also further divided into 4 groups based on PPI level, as PPI ≤0.40 （54 cases）, 0. 41 -0. 50（75 cases） ,0. 51 -0. 60（62 cases）, and 〉0. 60（29 cases）. ALB and blood lipid were determined by immune turbidimetric assay and the ALB level was compared among the groups. Results Sex, age and the abnormal blood lipid were not significantly different among the groups. With the increase of PP and PPI, ALB level in creased significantly （P 〈 0. 05 ）. The correlation coefficient （0. 416,0. 483 ） between PP, PPI and ALB level was higher than that between SBP,DBP and ALB level（O. 325,0. 302）. Conclusions There is close correlation between PP, PPI and ALB and they are more valuable than SBP and DBP in reflecting early renal injury in hypertensive patients.