原发性高血压患者血压变异性与早期肾功能损害的相关性研究

Relationship between blood pressure variability and early renal injury in patients with essential hypertension

目的:观察原发性高血压(EH)患者血压变异性与尿微量白蛋白/尿肌酐比值的相关性。方法:随机选择60例EH患者作为EH组,按照24h平均动脉压均值高度又分为3个亚组,即EH1组(90.2～106.6mmHg)、EH2组(106.6～118.3mmHg)及EH3组(118.3～143.7mmHg),各亚组均20例,另选择15例健康正常人作为健康对照组。监测所有研究对象在日间、夜间及24h收缩压变异性和舒张压变异性,以晨尿微量白蛋白/尿肌酐比值作为早期肾功能损害的指标,研究其相关性。结果:两组均存在血压变异性,与健康对照组比较,EH组日间、夜间及24h收缩压变异性[日间:(12.62±2.96)比(17.62±3.27),夜间:(8.32±2.14)比(11.63±2.35),24h:(11.23±2.25)比(18.35±2.94)]和舒张压变异性[日间:(10.32±2.41)比(12.48±2.85),夜间:(9.52±2.00)比(11.59±3.12),24h:(10.68±2.16)比(13.45±3.00)]均明显增大(P均<0.01)。双变量相关分析显示EH组及EH各个亚组的日间、夜间及24h收缩压和舒张压的血压变异性均与尿微量白蛋白/尿肌酐比值均呈正相关(r=0.217～0.485,P<0.05)。结论:原发性高血压患者血压变异性与早期肾脏损伤密切相关,改善血压变异性对预防早期肾功能损害有益。

Objective： To observe correlation between blood pressure variability and ratio of urinary microalbumin/urine creatinine in patients with essential hypertension（EH）.Methods：A total of 60 EH patients were regard as EH group and they were equally divided into EH1 group（90.2~106.6 mmHg）,EH2 group（106.6~118.3 mmHg） and EH3 group（118.3~143.7 mmHg） according to level of mean value of 24h mean arterial pressure.Another 15 healthy subjects were regard as healthy control group.Variabilities of systolic blood pressure（SBP） and diastolic blood pressure（DBP） of daytime,night and 24h were monitored in all subjects,and ratio of urinary microalbumin/urine creatinine in morning was regard as indicator for early renal injury,and their correlations were studied.Results：There existed blood pressure variability in both groups.Compared with healthy control group,there were significant increase in daytime,night and 24h SBP variability [daytime：（12.62±2.96） vs.（17.62±3.27）,night：（8.32±2.14） vs.（11.63±2.35）,24h：（11.23±2.25） vs.（18.35±2.94）]and DBP variability [daytime：（10.32±2.41） vs.（12.48±2.85）,night：（9.52±2.00） vs.（11.59±3.12）,24h：（10.68±2.16） vs.（13.45±3.00）]in EH group,P0.01 all.Bivariate correlative analysis showed Variabilities of SBP and DBP of daytime,night and 24h in EH group and subgroups of EH group were positively correlated with ratio of urinary microalbumin/urine creatinine（r=0.217~0.485,P0.05）.Conclusion： Blood pressure variability is closely related with early renal injury in patients with essential hypertension.Improvement of blood pressure variability is helpful for prevention of early renal injury.