原发性高血压患者尿微量白蛋白、超敏C反应蛋白、红细胞体积分布宽度间关系及临床意义

Correlation among microalbuminuria, high sensitivity C-reactive protein and red cell volume distribution width in patients with essential hypertension

目的探讨原发性高血压患者尿微量白蛋白（MAU）、超敏C反应蛋白（hs—CRP）、红细胞体积分布宽度（RDW）间关系及MAU危险因素。方法选择原发性高血压患者111例，按血压分级分为3组，高血压1级组14例，2级组42例，3级组55例。检测患者三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL-C）、hs—CRP、RDW、MAU、肌酐（Scr）、尿素氮（BUN）、糖化血红蛋白（HbA1c）、腰臀比（WHR）、体质量指数（BMI），询问高血压病程，调查有无吸烟、饮酒、糖尿病、冠心病病史等危险因素。结果3组比较，年龄、TC、TG、LDL—C、HDL—C、高血压病程、Scr、BUN、HbA1c、WHR、BMI、性别、吸烟、饮酒、糖尿病、冠心病病史差异均无统计学意义；而3组间MAU、hs—CRP、RDW差异均有统计学意义，高血压3级组较1级、2级组明屁升高[MAU：高血压1级组：（6．00±4．87）mg／24h，2级组：（7．37±5．86）mg／24h，3级组：（10．80±7．24）mg／24h；hs—CRP：高血压1级组：（1．11±0．48）mg／L，2级组：（0．90±0．35）mg／L，3级组：（1．49±0．79）mg／L；RDW：高血压1级组：（12．09±0．57）CV％，2级组：（12．20±0．69）CV％，3级组：（12．51±0．47）CV％，均为P〈0．05]；hs-CRP与MAU、RDW均呈正相关（r=0．336，P=0．002；r=0．269，P=0．042），MAU与RDW亦呈正相关（r=0．278，P=0．044）；Logistic多元回归分析显示，Scr（OR=1．131，P=0．032）、hs—CRP（OR=4．752，P=0．048）、RDW（OR=9．888，P=0．028）、糖尿病（OR=29．398，P=0．009）进入回归方程，是MAU的独立危险因素。结论原发性高血压患者MAU、hs—CRP、RDW互为相关，廊Scr、hs—CRP、RDW和糖尿病是高血压患者MAU的独立危险因素。MAU用于评估高血压患者发生肾脏并发症的危险程度及其治疗效果具有重要意义。

Objective To study the correlation among mieroalbuminuria （MAU）, high sensitivity C-reactive protein （hs-CRP） and red cell volume distribution width （RDW） in patients with essential hypertension and to investigate the influencing factors of mieroalbuminuria. Methods l,ipids, hs-CRP, RDW, MAU, Scr, BUN, HbAle, waist-to-hip ratio （WHR） , body mass index （BMI） , smoking, drinking, diabetes mellitus and coronary heart disease were analyzed in 111 essential hypertension patients （ 14 in grade 1 group, 42 in grade 2 group, 55 in grade 3 group）. Results There were no significant differences in age, TC, TG, LDL-C, HDL-C, Ser, BUN, HbAle, WHR, BMI, course of hypertension, history of diabetes and coronary heart disease, gender, drinking and smoking among three groups. Compared with grade 1 group and grade 2 group, MAU, hs-CRP, RDW were significantly higher in grade 3 group, Hs-CRP was positively correlated with MAU and RDW（ r = 0. 336, P = 0. 002 ; r = 0. 269, P = 0. 042）, MAU was also positively correlated with RDW （r =0. 278, P =0. 044）; Logistic regression analysis showed that Ser, hs-CRP, RDW and diabetes mellitus were significantly correlated with mieroalbuminuria. Conclusions MAU, hs-CRP and RDW are positively correlated with eath other; Scr （ OR = 1. 131, P =0. 032）, hs-CRP （ OR =4. 752, P =0. 048）, RDW （ OR =9. 888, P =0. 028） and diabetes mellitus （ OR = 29. 398, P = 0. 009 ） are the risk factors for microalbuminuria.