舟山渔区高血压患者微量白蛋白尿影响因素的研究

Influencing factors of Microalbuminuria in Patients with Essential Hypertension(EH) in Zhoushan Fishing Area

目的研究浙江舟山普陀渔区高血压患者微量白蛋白尿(MAU)相关因素。方法选取2011年1月至2012年4月在本院普通内科、高血压门诊及渔区2个社区原发性高血压患者(≥40岁)为研究对象,共180例(男96例,女84例),平均年龄(60.42±6.44)岁,记录患者年龄、性别、文化程度、高血压病程、收缩压(SBP)和舒张压(DBP)、体质指数(BMI)、吸烟饮酒、CCB(钙离子拮抗剂)与ACEI(血管紧张素转换酶抑制剂)联合用药、新鲜海鱼以及尿微量白蛋白/肌酐(UACR)、空腹血糖(FPG)、血脂(LDL-c、HDL-c、TG)、血尿酸(sUA)等。筛选出可能影响微量白蛋白尿的有关因素,然后对有统计学意义的变量进行多因素Logistic回归分析。结果 SBP、文化程度、体重指数、CCB和ACEI联合、血尿酸、空腹血糖、TG、LDL-c、HDL-c共9个指标与MAU的发生有统计学意义(P<0.05或P<0.01);影响高血压患者MAU发生的危险因素有SBP(P<0.01),FPG(P<0.01),sUA(P<0.01);CCB和ACEI联合(P<0.01)是保护因素。新鲜海鱼(Z=4.24,P<0.01)是MAU保护因素。结论收缩压、空腹血糖、血尿酸水平异常是渔区高血压患者MAU的危险因素;CCB和ACEI联合用药以及新鲜海鱼则可视为保护因素。

Objective To explore the influencing factors in patients with essential hypertension in fishing area of Putuo in Zhoushan, Zhengjiang Province. Methods From December 2010 to April 2012, a total of 180 hypertensive patients （96 men, 84 women, the av- erage age was （60.42 ± 6.44） ）whose age over 40 years old were recruited from Medical Clinic, Hypertension Clinic and 2 communi- ties in fishing area of Putuo. The baseline and labortorial materials information were collected including age, slender, fish, systolic blood pressure（SBP）, diastolic blood pressure（DBP）, BMI, education, duration of hypertension, smoking, alcohol, the combination of CCB and ACEI, urinary albumin-creatine ratio （UACR）, fasting plasmaglucose（FPG）, triglyceride（TG）, Low-density lipoprotein- cholesterol （LDL-c）, high-density lipoprotein-cholesterol（HDL-c）, serum uric acid（sUA）. The associated factors were evaluated by univariate chi-square test analysis, and then the statistical significant variables were analyzed by multivariate logistical regression. Re- suits SBP, culture stand, BMI, the combination of CCB and ACEI, sUA, FPG, TG, LDL-c, HDL-c were the important factors of developing MAU （ P 〈 0.05 or P 〈 0.01 ）. The independent risk factors related to MAU in hypertensive patients were SBP （ P 〈 0.01）, Ft~ （ P 〈 0.01）, sUA （ P 〈 0.01 ） ; the combination of CCB and ACEI was the protective factor of MAU （ P 〈 0.01 ）. Cochran-Mantel-Haenszel Chi square test indicates fish was also a protective factor （Z = 4.24, P 〈 0.01）. Conclusions SBP, FPG and sUA were risk factors associated with MAU in patients with EH in Putuo fishing area, and the combination of CCB and ACEI, fresh were both protetive factors.