原发性高血压中心动脉压及其反射波与微量白蛋白尿的相关研究

Correlation between microalbuminuria and central aortic pressure and its reflected wave in essential hypertension

目的探讨原发性高血压患者中心动脉压及其反射波变化与微量白蛋白尿的相关关系。方法选择该院行冠状动脉造影(CAG)且尿蛋白阴性的原发性高血压患者102例,根据尿白蛋白排泄率(UAE)结果分为微量白蛋白尿组(60例)和对照组(42例)。应用导管法测定主动脉根部压力并对其波形进行分析。比较两组中心动脉收缩压(CSP)、中心动脉舒张压(CDP)、主动脉输出压(PI)、脉压(PP)、反射波增强压(AP)、反射波增强指数(AI)和起始时间(IT);并对所有患者尿白蛋白水平与中心动脉压及其反射波参数进行相关分析。结果与对照组相比,微量白蛋白尿组CDP显著降低、PP增大、AP增高、AI增大、起始时间提早;尿微量白蛋白水平与CSP、CDP、PP、AP、AI及IT具有显著相关性。结论原发性高血压患者中心动脉脉压增大、反射波增强压力增高、压力增强指数增大及反射波提早出现与其微量白蛋白尿的发生密切相关。

[Objective] To study the correlation between microalbuminuria and central aortic pressure and its reflected wave in essential hypertension. [Methods] 102 essential hypertension patients with negative regular urinary albumin testing undergone coronary angiography （CAG） were divided into the microalbuninuria （MAU） group and the control group according to urinary albumin excretion （UAE）. Central systolic pressure （GSP）, diastolic pressure （CDP）, aortic pressure of impulse （PI）, pulse pressure （PP）, the augmented pressure （AP）, augmentation index （AI） and initiated time （IT） of central aortic reflected wave were compared between the two groups. To investigate the relationship between the level of central aortic pressure, reflected wave and microalbuminuria by means of Pearson correlation analysis. [Results] The CSP and PI were similar in the two groups, but CDP was significantly reduced in MAU group compare with control group. The AP, PP and AI were significantly increased and the IT was shortened in MAU group than in control group. The level of microalbuminuria was related to CSP, CDP, PP, AP, IT and AI. [Conclusion] Central aortic pulse pressure, systolic pressure, diastolic pressure, the augmented pressure, augmentation index and initiated time are significantly correlated to MAU in essential hypertension.