高血压病患者尿微量白蛋白与氧化应激、血管内皮功能的相关性研究

Association of the oxidative stress and brachial artery endothelial function with the microalbuminuria in hypertensive patients

目的探讨高血压病患者尿微量白蛋白与氧化应激、血管内皮功能关系。方法根据尿微量白蛋白量将86例高血压病患者分为尿微量白蛋白阳性组(≥30mg/24h)组(MA组,n=47)、尿微量白蛋白正常组(<30mg/24h)组(NMA组,n=39)。抽血化验血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)的活性及氧化低密度脂蛋白抗体(OLAb)滴度,并用彩色多普勒测量肱动脉内皮功能(Flow-MD),留取24h尿测量微量白蛋白。结果与NMA组比较,MA组的血清SOD、GSH-PX的活性下降、氧化低密度脂蛋白抗体(OLAb)滴度明显升高,并伴有肱动脉内皮功能损害增加(P<0.01)。结论与尿微量白蛋白阴性的高血压病患者相比,高血压病伴有尿微量白蛋白阳性患者有较严重内皮功能损害和较高水平氧化应激状态,提示氧化应激和血管内皮功能异常在高血压早期肾损害可能起重要作用。

Objective To investigate possible associations between oxidative stress and brachial artery endothelial function with the microalbuminuria in hypertensive patients.Methods 47 hypertensive patients with microalbuminuria（≥30mg/24h）（MA group）,39 hypertension patients without microalbuminuria（30mg/24h）（NMA group） were enrolled.Serum level of superoxide dismutase（SOD）,glutathione peroxidase（GSH-Px）and antibody against oxidized low density lipoprotein（OLAb） was measured.The brachial artery flow-mediated dilatation of all subjects was measured noninvasively by the same ultrasound machine.Results Compared to the hypertensive patients without microalbuminuria group,serum SOD,GSH-Px were lower and OLAb was significantly higher（P〈0.01） in the hypertensive patients with microalbuminuria group.Correlation analysis showed that microalbuminuria was positively correlated with OLAb,and was negatively correlated with serum SOD and GSH-Px.Conclusions Oxidative stress is increased in hypertensive patients with microalbuminuria compared to hypertensive patients without microalbuminuria and this increase seems to be related to the severity of microalbuminuria levels.Suggesting that oxidative stress and endothelial function plays an important role in the development of early renal damage in essential hypertension.