老年原发性高血压患者血糖及脂质改变对微量白蛋白尿的影响

The primary factors influencing micro-albuminuria in aged hypertensives

目的 :探讨老年原发性高血压 (EH)患者微量白蛋白尿 (MAU )的主要影响因素及其意义。方法 :选择不伴有糖尿病及原发性肾脏疾病的老年 EH患者 81例 ,采用放射免疫法测定早晨第 1次尿中微量白蛋白 ,将其分为 MAU阳性及阴性两组 ,并对所有患者测定血清脂质各项指标、空腹血糖 (FBG)、血胰岛素 (FIns)及 C肽(FC- P) ,计算胰岛素敏感性指数 (ISI) ,进行统计分析。结果 :EH伴 MAU阳性组血清甘油三酯 (TG) (2 .35±1.2 3) mm ol/ L、低密度脂蛋白胆固醇 (L DL- C) (3.89± 1.78) mmol/ L、载脂蛋白 B(apo B) (12 8± 5 3) m mol/ L、脂蛋白 (a)〔L p(a)〕(30 7.13± 196 ) m mol/ L 显著增高 (P <0 .0 5 ,P <0 .0 1)。而高密度脂蛋白胆固醇 (HDL- C) (1.2 2± 0 .2 0 ) m mol/ L、载脂蛋白 A(apo A ) (137.2 2± 10 4) mm ol/ L较低 (P <0 .0 5 )。 ISI(- 4.71± 0 .5 2 )显著低于MAU阴性组 (NMAU ) (P <0 .0 5 )。结论 :在不伴有糖尿病及原发性肾脏疾病的 EH患者中 ,脂质代谢紊乱及胰岛素抵抗可能在 MAU的发生过程中有一定作用。

Objective:To investigate the primary factors influencing micro albuminuria (MAU) in aged hypertensives.Method:81 aged hypertensives without diabetes and primary kidney disease were included in this study.Radioimmunoassay was employed to determine MAU in first urine in the morning.Based on above result,the patients were divided into two groups:MAU group and NMAU group.The important index of serum lipid、FBG、FIns and FC P were determined and the insulin index (ISI) was calculated at the same time.Result:There were significant increase of TG,LDL C,apoB,Lp(a) (P< 0.01 ) and marked decrease of HDL C、apoA in MAU group (P< 0.05 ).Conclusion:This study suggests that the increase of TG,LDL C,apoB,Lp(a) and decrease of HDL C,apoA in aged hyperpietics without diabetes and primary kidney disease may play an important role in the pathogenesis of MAU.