动态血压均值及动态脉压对高血压早期肾损害的预测

Value of 24 h mean blood pressure and pulse pressure in perdicting early renal impairment in essential hypertension patients

目的:探讨动态血压均值及动态脉压对原发性高血压患者早期肾损害的预测价值。方法:原发性高血压患者125例按24小时动态脉压(24hPP)分为四组:Ⅰ组:≤40mmHg、Ⅱ组:41～55mmHg、Ⅲ组:56～70mmHg、Ⅳ组:>70mmHg。测量24h平均收缩压(24hSBP)、24h平均舒张压(24hDBP)、24hPP及尿微量白蛋白(MAN)。比较各组的MAN检测值及其阳性率。行24hSBP、24hDBP。24hPP与MAN的关回归分析。结果:24hSBP、24hPP与MAN呈正相关(r=0.78、0.79,P<0.05),24hDBP与MAN呈负相关(r=-0.64,P<0.05)。进一步建立一元线性回归方程,得出与早期肾损害对应的24hSBP、24hDBP及24hPP值分别为150mmHg、91mmHg、58mmHg。结论:动态血压均值及动态脉压可作为高血压患者早期肾损害的预测指标。

Objective： To investigate the predict value of 24-hour mean blood pressure and pulse pressure in early renal impairment in patients with essential hypertension （EH）. Methods： The 125 EH patients were divided into four groups on the basis of the 24 h mean pulse pressure （24hPP）： group Ⅰ（≤40mmHg）, group Ⅱ（41-55mmHg）, groupⅢ（56-70 mmHg ）, groupⅣ（〉70mmHg）. The data was collected and studied, which includes 24 h mean systolic blood pressure （24hSBP）. 24 h mean diastolic blood pressure （24hDBP） , 24hPP of ABPM and microalbuminuria （MAN）. The MAN and its positive rate in each group were compared respectively. Correlation among 24hSBP, 24hDBP, 24hPP and MAN was analyzed. Results： The MAN was positively correlated with 24hSBP and 24hPP （r=0. 78. 0. 79, P〈0. 05） and negatively correlated with 24hDBP （r= -0. 64, P〈0. 05）. The 24hSBP 150mmHg, 24hDBP 91mmHg, 24hPP 58mmHg were corresponded with early renal impairment according with single equation of linear regression. Conclusion： The 24hSBP, 24hSBP and 24hPP can be considered as predict indexes of hypertensive renal impairment.