原发性高血压患者脉压指数与尿微量白蛋白的关系

Relationship between pulse pressure index and urine microalbum in patients with essential hypertension

目的探讨原发性高血压患者动态脉压及脉压指数与肾功能损害的相互关系。方法对225例原发性高血压患者进行动态血压监测,计算研究对象的脉压和脉压指数,按脉压(>60mmHg与≤60mmHg)和脉压指数(>0.45与≤0.45)进行分组,观察各组血尿素氮、肌酐、尿酸及尿微量白蛋白变化及其与脉压、脉压指数的相关性。结果脉压>60mmHg组和脉压指数>0.45组上述肾功能指标中尿酸、尿微量白蛋白明显高于脉压≤60mmHg组和脉压指数≤0.45组;偏相关分析显示,尿微量白蛋白与收缩压(r=0.305,P<0.05)、脉压(r=0.402,P<0.01)和脉压指数(r=0.689,P<0.01)呈正相关。结论脉压指数能更灵敏的反映肾脏早期损害,是肾脏早期损害的重要危险因子。

Objective To investigate the relationship between dynamic pulse pressure （PP）, pulse pressure index（PPI） and renal damage in patients with essential hypertension （EH）. Methods The twenty-four hours＇ ambulatory blood pressure （24 h ABP） was monitored in 225 patients with EH. The patients were divided into different groups according to the levels of ambulatory PP（APP）（≥61 mm Hg or 460 mm Hg） and PPI（≥0. 46 or 40.45）. The association of the blood BUN, UA, Cr and urine microalbum（UmAlb） with PP and PPI was analyzed. Results UmAlb and UA were significantly higher in PP≥61 mm Hg and PPI≥0.46 groups than that in PP460mmHg and PPI4 0.45 groups （P〈0.01）. After adjustment for age, weight, body mass index （BMI） and diastolic blood pressure （DBP）, there was a positive relationship between UmAlb and SBP （r= 0. 305, P〈 0.05） and PP（r=0. 402, P〈0. 01） and PPI（r： 0. 689, P〈0. 01）. Conclusion There is a correlation between SBP, PP, PPI and UmAlb. PPI can sensitively predict the early renal impairment, and it＇s the important risk factor of early renal impairment.