高血压病患者微量白蛋白尿与动脉病变关系的研究

Association of Microalbuminuria and Arterial Damage in Hypertension Patients

目的:分析高血压病伴及不伴微量白蛋白尿患者的动脉结构及功能的差异。方法:入选高血压病患者307例,对入选患者分别进行晨尿白蛋白/肌酐测定、大动脉弹性指数、小动脉弹性指数、颈—股动脉脉搏波传导速度(cfPWV)和颈动脉超声检查。根据尿白蛋白/肌酐测定结果将入选患者分为正常组(n=232)和异常组(n=75),应用统计学方法进行动脉功能和结构指标的组间差异比较。结果:①大动脉弹性指数和小动脉弹性指数在异常组均低于正常组;②cfPWV在异常组显著高于正常组;③应用Logistic回归进行多元分析,小动脉弹性指数和cfPWV在两组之间的差异仍存在;④颈动脉内膜中层厚度在异常组显著高于正常组,Logistic回归去除年龄、性别、高血压病程和糖尿病等影响因素后组间差异仍存在;⑤异常组颈动脉斑块检出数显著高于正常组。以上P均<0.05～0.01,差异均有统计学意义。结论:微量白蛋白尿和动脉功能、结构异常在高血压病情判断中可能具有一定的应用价值。

Objective：To investigate the association between microalbuminuria and arterial structure and function change in hypertension patients. Methods：Three hundred and seven hypertension patients were enrolled in. All subjects underwent laboratory measurements albumin of excretion rate. Carotid to femoral pulse wave velocity （PWV）, C1 and C2 were measured. All these patients were examined by B-mode ultrasound to measure intima media thickness （IMT） at the far wall of the common carotid artery and plaque formation. All subjects were divided into two groups, normal and abnormal, according to the result of albumin excretion rate. Difference of arterial function, IMT and plaque formation between two groups were analyzed. Result：（1） C1 and C2 were lower in abnormal albumin/creatinine ratio group. （2） PWV was higher abnormal albumin/creatinine ratio group. （3） Difference of C2 and PWV between two groups still exists after analysed using Logistic regression. （4） IMT was thicker in abnormal group even after analysed using Logistic regression. （5） More plaques in carotid artery were detected in abnormal albumin/creatinine ratio group. Conclusion ： Microalbuminuria, arterial structure and function were useful for judgement of hypertension patents＇ prognosis.