不同心率指标对原发性高血压病患者尿微量清蛋白的影响及相关性研究

Correlation between Heart Rate Parameters and Urinary Minim Albumin in Patients with Essential Hypertension

目的探讨不同心率指标对原发性高血压病(EH)患者尿微量清蛋白(MAU)的影响。方法选取2011年11月—2013年7月在我院住院的EH患者206例,血压水平在1、2级。检测患者的24 h平均心率(AHR)、日间平均心率(DHR)、夜间平均心率(NHR)、静息心率(RHR)、夜间心率下降率(NHD)及24 h尿MAU水平。根据AHR、DHR、NHR、RHR水平的高低,将患者分为3级:A级(心率<70次/min)、B级(70次/min≤心率<80次/min)和C级(心率≥80次/min)。并根据NHD,将患者分为两型:杓型(NHD≥10%)和非杓型(NHD<10%),比较不同分级及不同分型间尿MAU水平,并探讨各心率指标与尿MAU的关系。结果 (1)AHR、DHR、NHR、RHR不同分级间尿MAU水平比较,差异均有统计学意义(P<0.05);且随着AHR、DHR、NHR、RHR的升高,尿MAU水平亦增加(P<0.05)。非杓型患者尿MAU水平高于杓型患者〔(50.6±24.5)mg/24 h与(37.4±22.6)mg/24 h,t=26.24,P=0.000〕。(2)Pearson相关分析显示,AHR、DHR、NHR、RHR均与尿MAU呈正相关(r值分别为0.754、0.729、0.795和0.786,P<0.05);而NHD与尿MAU呈负相关(r=-0.398,P<0.05)。结论 EH患者不同心率指标对其尿MAU有一定的影响。在控制血压的同时,控制各心率指标及心率昼夜节律,可以减少EH患者尿MAU水平。其中,NHR、RHR、AHR与EH患者尿MAU的关系较为密切。

Objective To study the influence of heart rate parameters on urinary minim albumin （MAU） in patients with essential hypertension （EH） . Methods 206 EH patients admitted to our hospital from November 2011 to July 2013 were selected and their hypertension level was between level 1 and level 2. The 24 h average heart rate （ AHR）, daily heart rate （DHR）, night heart rate （NHR）, resting heart rate （RHR）, night heart rate drop rate （NHD） and urinary MAU level were detected. The patients were divided into three levels according to the levels of AHR, DHR, NHR and RHR ： level A （ heart rate 〈 70/min）, level B （70/min ≤ heart rate 〈 80/min） and level C （heart rate≥ 80/min） . The patients were also divided into two types according to NHD ： Dipper Group （ NHD ≥ 10% ） and non - Dipper Group （ NHD 〈 10% ） . Urinary MAU level of pa- tients with different levels and different types were compared, and the relationship between heart rate parameters and urinary MAU was studied. Results （ 1 ） The urinary MAU between different levels of AHR, DHR, NHR and RHR showed statistically significant difference （ P 〈 0. 05 ）, and with the increase of AHR, DHR, NHR and RHR, the urinary MAU level also in- creased （ P 〈 0. 05 ） . Non - Dipper patients had higher urinary MAU level than Dipper patients [ （50. 6 ± 24. 5 ） rag/24 h vs. （37. 4 ± 22. 6） mg/24 h, t = 26. 24, P = 0. 000 ] . （2） Pearson correlation analysis showed that AHR, DHR, NHR and RHR were all positively correlated with urinary MAU （ r = 0. 754, 0. 729, 0. 795 and 0. 786, P 〈 0. 05 ） . NHD was negatively correlated with urinary MAU （ r = - 0. 398, P 〈 O. 05 ） . Conclusion Heart rate parameters has certain influence on urinary MAU in EH patients. Heart rate should be controlled together with the regulation of blood pressure can reduce the urinary MAU level in EH patients. NHR, RHR and AHR are closely related with urinary MAU in EH patients.