尿微量清蛋白在高血压病早期肾损伤的意义及其与低级别炎症的关系

Significance of Microalbuminuria in Essential Hypertensive Subjects With Early Renal Injury and its Relation to High-sensitive C-reactive Protein

目的探讨高血压病尿微量清蛋白(MA)与高敏C-反应蛋白(hsCRP)等指标间的相关性。方法测定108例高血压病患者尿清蛋白排泄率(UAER)和高敏C-反应蛋白(hsCRP)浓度及其他生化指标,比较正常清蛋白尿组和微量清蛋白尿组间hsCRP浓度,并分析MA与hsCRP的关系。结果微量清蛋白尿组患者的收缩压、脉压、纤维蛋白原和hsCRP明显升高。UAER与收缩压、脉压、体重指数(MBI)、血清肌酐(SCr)、纤维蛋白原和hsCRP分别呈正相关(P均<0.05)。多元回归分析发现,脉压、血清肌酐和hsCRP与UAER呈独立相关。结论MA是高血压病早期肾功能损伤的敏感指标。hs-CRP是MA独立的危险因子,提示炎症反应可能与早期肾损伤有关。

Objective To investigate the association between microalbuminuria （MA） and high - sensitive C - reactive protein in essential hypertensive subjects. Methods Urinary albumin excretion rate （UAER） and the concentrations of high - sensitive C - reactive protein（ hs- CRP） were measured. One hundred and eight patients with hypertension were divided into 2 groups： normoalbuminuria and microalbuminuria group, concentrations of hs - CRP was compared between the two groups , and the association between MA and hs - CRP was evaluated. Results Patients with microalbuminuria were significantly characterized by higher systolic blood pressure （ SBP ） , pulse pressure（PP） ,circulating fibrinogen and hs -CRP. Evaluation of bivariate correlation indicated that UAER was positively correlated with SBP , PP , body mass index （BMI） ,Serum creatinine （SCr） , fibrinogen and hs - CRP. Multivariate regression analysis demonstrated PP, SCr and hs - CRP were independent risks associated with UAER. Conclusions Microalbuminuria is a sensitive marker in essential hypertensive subjects with early renal injury . hs- CRP is an independent risk associated with UAER ,which suggests that inflammation correlate with early renal injury in essential hypertension.