轻度妊高征患者动态血压变化与尿微量白蛋白排泄率的关系探讨

Study on relationship between the change of ambulatory blood pressure and urinary albumin excretion rate in patients with mild pregnancy hypertension syndrome

目的探讨轻度妊高征患者动态血压变化与尿微量白蛋白排泄率(UMAE)的关系。方法选择轻度妊高征患者(轻度妊高征组)68例和正常晚期妊娠的孕妇(正常妊娠组)76例,动态监测两组孕妇的24 h血压变化,同步监测UMAE变化情况,分析两者之间的相关性。结果轻度妊高征组孕妇24 h收缩压或舒张压平均血压、血压负荷均显著高于正常妊娠组孕妇(P均<0.05);昼夜平均血压差低于正常妊娠组(P<0.05);轻度妊高征组孕妇UMAE(50,6±32,4)mg/d,显著高于正常妊娠组(15.1±9.5)mg/d(P<0.05);轻度妊高征患者24 h动态血压变化与UMAE呈正相关。结论轻度妊高征患者血压昼夜规律性变化消失,与其早期肾脏损害存在密切相关性;妊娠期间24 h监测动态血压与UMAE,有重要的临床指导意义。

Objective To investigate the relationship between the changes of ambulatory blood pressure and urinary albumin excretion rate in patients with mild pregnancy hypertension syndrome. Methods Sixty-eight patients with mild pregnancy hypertension syndrome and 76 normal late pregnancy women were selected. In two groups, the 24 h dynamic blood pressure were monitored, simultaneously monitoring the urine albumin excretion rate for analysis of the correlation between the two indexes. Results The 24 h systolic or diastolic blood pressure and mean blood pressure load in mild pregnancy hypertension group were higher than those in normal pregnancy group（ all P 〈 0. 05 ）. The mean diurnal blood pressure in mild pregnancy hypertension group was （ 8.2 ± 2. 6 ） %. And the mean diurnal blood pressure in normal pregnancy group was （ 16.2 ± 2.4 ） % , there was a significant difference between two groups （P 〈 0. 05 ）. The urinary albumin in mild pregnancy hypertension group was （50. 6 ± 32.4 ） mg/d, and higher than that in normal pregnancy group[ （ 15.1 ± 9. 5 ） mg/d], the difference was statistically significant （ P 〈 0. 05 ）. In patients with mild pregnancy hypertension syndrome, there was a positive correlation between the change of 24 h ambtdatory blood pressure and urinary albumin excretion rate. Conclusion In patients with mild pregnancy hypertension syndrome the change of pressure circadian disappeared, and there is close correlation between This change and early kidney damage;during pregnancy the monitoring of 24 h ambulatory blood pressure and urine albumin excretion rate has an important clinical significance.