正常血压高值与肾功能的相关性研究

The relationship between prehypertension and renal function

目的:观察正常血压高值患者肾功能的变化,以探讨正常血压高值患者是否存在与血压升高相关的靶器官损害,以指导其治疗和预防。方法:根据JNC-7诊断标准筛选病例并分为3组:正常血压组(NT组)56例;正常血压高值组(PH组)51例;高血压组(EH组)54例。留取晨尿,抽取静脉血,离心后采用放免法和酶法测定尿β2-微球蛋白(β2-MG)、尿微量白蛋白(mAIb)及血尿素氮(BUN)、血肌酐(Cr)。结果:与NT组相比,PH组和EH组尿β2-MG、mAIb水平明显升高(P<0.05;P<0.01);BUN、Cr在EH组明显升高,与NT组比较P<0.01;在PH组BUN轻度升高,与NT组比较无显著性差异;血Cr明显升高,与NT组比较P<0.01。直线相关分析显示:血压水平与尿β2-MG、mAIb及BUN、Cr的水平均呈显著正相关。多因素回归分析显示:校正年龄、体质指数、血糖、胆固醇、TG,血压水平仍与尿β2-MG、mAIb有显著的相关性。结论:PH组患者尿β2-MG、mAIb、Cr出现了异常变化。且血压水平与尿β2-MG、mAIb及BUN、Cr的水平均呈显著正相关。提示正常血压高值患者可能存在与血压升高相关的肾损害。血压水平是导致尿β2-MG、尿mAIb增加的独立危险因素。

Objective：This study investigates the renal function in prehypertensive patients. Methods：Patients were scruited according to JNC-7 and divided into three groups： 56 normotensive subjects （NT group, 41 males, mean age [45.54± 6.1]years old） ; 51 prehypertensive patients （PH group, 37 males, mean age [46.04 ± 6.2] years old） ;and 54 hypertensive patients （EH group,40 males, mean age [49.06±5.3] years old）. Urine i32-MG, urine mAIb, serum BUN and Cr were determined by radioimmunoassay and enzyme linked immnosorbent assay. Resulturine β2-MG and mAIb were significantly higher in the PH and EH groups compared to NT group（P〈 0.05; P〈0.01）. Serum BUN and Cr were significantly increased in the EH group than that in NT group （P〈 0.01）. Serum BUN was little increased in the PH group, it wasn＇t significance of difference PH group and NT group; but serum Cr was significantly increased in the PH group than that in NT group （P〈0.01） . The straight line correlation analyses demonstrated that the leve of urine β2-MG, urine mAIb, serum BUN and Cr were associ- ated with the leve of blood pressure . Multiple linear regression analyses showed that the level of blood pressure still associated with the leve of urine β2-MG, urine mAIb,adjusting age, body mass index, blood sugar, the cho- lesterol and the triglyceride. Conclusion：Urine β2-MG, urine mAIb and serum Cr were increased in prehypertens- ive patients. The leve of urine β2-MG, urine mAIh, serum BUN and Cr were associated with the leve of blood pressure. Adjusting age, body mass index, blood sugar, the cholesterol, the triglyceride, the level of blood pres sure still associated with the leve of urine β2-MG, urine mAIb. It prompts that the related kidney harm occurred in prehypertensive patients. The level of blood pressure was the independen hazard factor which caused urine β2-MG and mAIb.