122例老年原发性高血压病患者不同证型间早期肾损害尿蛋白比较分析

Difference of Urine Protein During the Stage of Early Renal Damage in Elderly Primary Hypertensive Patients with Different Traditional Chinese Medical Syndrome Types:An Analysis of 122 Cases

目的:分析老年原发性高血压病患者不同中医证型之间早期肾损害尿蛋白的差异性,为中医辨证分型及早期诊疗高血压肾损害提供依据。方法:采用观察研究病例资料的方法,在北京市延庆县井庄镇地区收集122例老年原发性高血压病患者,分为痰瘀阻络组、阴虚阳亢组及肾虚组3组。留取患者晨起尿液标本,检测早期肾损害指标β2-微球蛋白(β2-MG)、微量白蛋白(MALB)、转铁蛋白(TRF)。将各证型组早期肾损害指标进行统计分析。结果:所占比例痰瘀阻络组为32%,阴虚阳亢组为36%,肾虚组为32%。3个证型中阴虚阳亢组所占比例稍大,但与另外2组比较,差异无显著性意义(P>0.05)。肾虚组尿MALB、TR F、β2-MG与痰瘀阻络组、阴虚阳亢组比较,水平均增高(P<0.05,P<0.01);痰瘀阻络组与阴虚阳亢组比较,3项指标差异均无显著性意义(P>0.05)。结论:不同证型老年原发性高血压病患者均存在早期肾损害,但肾虚证患者的早期肾损害程度总体上要重于痰瘀阻络证及阴虚阳亢证患者。

Objective. To analyze the differences of urine protein during the stage of early renal damage in the elderly primary hypertensive patients with different traditional Chinese medical synd＇rome types, thus to provide evidence for syndrome differentiation and early diagnosis and treatment of hypertensive renal damage, Methods. Case files of 122 elderly primary hypertensive patients were collected from Jiangzhuang town of Yanqing county, Beijing. The patients were differentiated into 3types, phlegm and blood stagnation obstructing meridian, yang hyperactive due to yin deficiency, and kidney deficiency. The urine indexes of early renal damage such as beta2-macroglobulin（β2-MG）, micro-albumin （MALB）, and transferring （TRF） were detected and analyzed in patients with different syndrome patterns by statistical analysis. Results- Of 122 cases, patients with phlegm and blood stagnation obstructing meridian accounted for 32%, yang hyperactive due to yin deficiency accounted for 36%, and kidney deficiency accounted for 32%, the differencebeing insignificant （P 〉 0.05）. Patients with kidney deficiency had higher levels of MALB, TRF and β2-MG than the other two syndrome patterns （P 〈 0.05 or P 〈 0.01）, but the differences of MALB, TRF and 152-MG between the syndrome of phlegm and blood stagnation obstructing meridian and the syndrome of yang hyperactive due to yin deficiency were insignificant （P 〉 0,05）. Conclusion. Early renal damage occurs in all of the elderly primary hypertensive patients, and the damage degree in kidney deficiency patients is severer than patients with the syndrome of phlegm and blood stagnation obstructing meridian, and the syndrome of yang hyperactive due to yin deficiency.