子痫前期患者血压水平与肾脏损害的关系

Correlation Between Blood Pressure and Renal Injury in Patients with Pre-eclampsia

【目的】探讨子痫前期患者的血压水平与蛋白尿及肾功能之间的关系。【方法】收集本院2004年至2007年间收治的114例子痫前期患者的血压、尿蛋白、血清肌酐等资料，回顾性分析血压水平与蛋白尿及估算的肾小球滤过率（eGFR）之间的关系。【结果】114例患者中，平均动脉压及收缩压水平与24h尿蛋白排泄量均呈正相关，相关系数（r）分别为0．53（Pd0．01）和0．58（P〈0．01），舒张压与24h尿蛋白排泄量无关，r=0．16（P〉0．05），而平均动脉压、收缩压及舒张压均与eGFR不相关（r=-0．14，0．01，-0．18，均P〉0．05）。但进一步通过亚组分析发现，在收缩压≥140mmHg的78例患者中，平均动脉压和收缩压均与eGFR呈负相关（r=-0．39，P〈0．01和r=-0．28，P〈0．05）；而在单纯舒张压≥90mmHg的24例患者中，舒张压则与eGFR不相关（r=0．06，P〉0．05）。【结论】子痫前期患者的血压水平与蛋白尿排泄量之间存在明确的相关性，在收缩压〉140mmHg的患者中，肾功能损害程度随血压升高而加重。

[Objective]To explore the correlation of blood pressure with proteinuria and renal function in patients with pre-eclampsia. [Methods] The data such as blood pressure, urine protein and serum creatinine of 114 patients with pre-eclampsia in our hospital from Oct. 2004 to Oct. 2007 were collected. The correlation method was used to analyze the relationship of blood pressure and proteinuria with estimated glomerular filtration rate（eGFR） retrospectively. [Results]Of 114 patients, mean arterial pressure （MAP） and systolic blood pressure （SBP） were positively correlated to 24h urine protein excretion（TPE）（ r = 0.53, P d0.01 and r = 0.58, P d0. 0001, respectively）, while diastolic blood pressure（DBP） was not correlated to TPE（ r = 0.16, P 〉0.05）. MAP, SBP and DBP were not correlated to eGFR（ r = -0.14, 0.01,-0. 18, all P 〉0.05）. However, the analysis results of the subgroups of 78 patients with SBP≥140 mmHg showed that MAP and SBP were negatively correlated to eGFR（ r = -- 0.39, P d0.01 and r = -0.28, P 〈0.05, respectively）. In 24 patients with DBP≥90mmHg, DBP was no correlated to eGFR （ r = 0.06, P 〉0.05）. [Conclusion]There is certain correlation between blood pressure and TPE in patients with pre-eclampsia. In patients with SBP≥ 140 mmHg, renal function injury aggravates with the increasing of blood pressure.