正常高值血压患者微量蛋白尿与超敏C反应蛋白、肿瘤坏死因子-α的相关性研究

The relationship between microalbuminuria and the levels of TNF-a and hs-CRP in prehypertensive subjects

目的 探讨正常高值血压患者炎症因子水平与微量蛋白尿之间的关系,为高血压的早期诊断和预防提供依据.方法 选取符合条件的正常高值血压（血压120～ 139/80～89mmHg）患者70例,另选35例理想血压（血压＜ 120/80mmHg）志愿者作为对照组,检查受试者超敏C反应蛋白（hs-CRP）、血清肿瘤坏死因子（TNF）-α和尿液TNF-α及尿蛋白水平,分析血压水平、炎性因子和微量蛋白尿三者之间的相关性.结果 正常高值血压患者炎性因子、尿白蛋白含量相对理想血压者存在明显差异；有微量蛋白尿的正常高值血压患者血清hs-CRP和尿TNF-α含量增高；多元回归分析显示收缩压（r =0.30,P=0.01）、hs-CRP（r =0.30,P＜0.01）、尿TNF-α（r=0.70,P＜0.01）与尿白蛋白存在独立相关性.结论 正常高值血压患者炎性因子与微量蛋白尿存在相关性,炎症介质可能是早期靶器官损伤的致病因子.

Objective To evaluate the relationship between the levels of TNF-α、hs-CRP and microalbuminuria（MAB） in prehypertension,and provide evidence for early diagnosis and prevention of hypertension.Methods A total of 70 prehypertensive subjects（blood pressure 120-139/80-89 mm Hg） and 35 healthy volunteers（blood pressure 120/80 mm Hg） were included.We measured inflammatory factor （high-sensitivity C-reactive protein（hs-CRP）,serum and urinary tumor necrosis factor-α） and arinary albumin excretion （UAE）,the relationship between the blood pressure levels,inflammatory factors,and microalbuminuria was analysed.Results Prehypertensive individuals had higher inflammatory factors and UAE than the optimal blood pressure volunteers;prehypersive patients with MAB had higher hs-CRP and urinary TNF-α; multiple regression analysis suggested systolic blood pressure （r =0.30,P =0.01）,hsCRP（r =0.30,P ＜ 0.01） and urinary TNF-α （r =0.70,P ＜ 0.01） was independetly correlated with UAE.Conclusions There is a relationship between the inflammatory factors and MAB,inflammatory mediator may be a pathogenic factor for early target-organ damage （TOD） in prehypertension.