不同中医证型原发性高血压病患者早期肾功能损害指标比较

Comparison of Early Kidney Damage Indicators in Primary Hypertensive Patients with Different TCM Syndromes

目的探讨不同中医证型原发性高血压病患者早期肾功能损害指标尿N-乙酰β-D氨基葡萄糖苷酶(NAG)及血清胱抑素C(Cyst-c)的差异。方法 240例原发性高血压病患者中痰瘀阻络型78例、阴虚阳亢型84例及肾虚型78例。留取患者空腹静脉血、晨起尿液标本,检测各证型患者尿NAG及血清Cyst-c水平。结果痰瘀阻络型尿NAG水平显著低于肾虚型(P<0.05),其余证型尿NAG水平比较差异无统计学意义(P>0.05)。痰瘀阻络型、阴虚阳亢型、肾虚型的血清Cyst-c水平依次增高,且两两比较差异有统计学意义(P<0.01)。结论原发性高血压病患者中,肾虚证患者的尿NAG、血清Cyst-c水平高于痰瘀阻络证和阴虚阳亢证患者,肾虚证患者的早期肾损害程度重于痰瘀阻络证和阴虚阳亢证患者。

Objective To compare the differences in urine N-Acetyl-beta-D-glucosaminidase （NAG） and serum Cyst-c in pri- mary hypertensive patients with different TCM syndromes. Methods Totally 240 cases of primary hypertension were random- ized into the phlegm-stasis obstructing the network vessels group （78 cases）, yin deficiency with yang hyperactivity group （84 cases） and kidney deficiency group （78 cases）. The urine NAG and serum Cyst-c were detected and compared. Results The phlegm-stasis obstructing the network vessels syndrome accounted for 32.5 %, yin deficiency with yang hyperactivity syndrome accounted for 35.0~ and kidney deficiency syndrome accounted for 32.5 ~ in 240 patients, but with no significant difference between syndromes （P^0.05）. The urine NAG in the phlegm-stasis obstructing the network vessels group was significantly lower than that in the kidney deficiency group （P^0.05）. The serum Cyst-c was gradually increased in the phlegm-stasis ob- structing the network vessels group, yin deficiency with yang hyperactivity group and kidney deficiency group, and the pairwise comparison showed a significant difference between groups （P%0.01）. Conclusion Comparing with primary hypertensive pa- tients with phlegm-stasis obstructing the network vessels syndrome and yin deficiency with yang hyperactivity syndrome, the levels of urine NAG and serum Cyst-c in primary hypertensive patients with kidney deficiency syndrome are higher and the early kidney damage is more severe.