原发性高血压患者昼夜血压节律异常与尿微量白蛋白的关系

Relationship of abnormal circadian rhythm of blood pressure and microalbuminuria of patients with essential hypertension

目的研究原发性高血压患者昼夜血压节律变化与尿微量白蛋白的关系。方法将188例原发性高血压患者根据夜间收缩压下降百分比分为A(非杓型组)、B(杓型组)两组,并设30例健康体检人群为对照(C组),记录各组患者一般资料、24 h动态血压、空腹血糖、胆固醇以及尿微量白蛋白并比较,分析昼夜血压节律变化与尿微量白蛋白的关系。结果 A组患者尿微量白蛋白水平较B组、C组明显升高(P<0.01);A组患者尿微量白蛋白水平受多种因素影响,其中日间平均收缩压(dSBP)、24 h平均收缩压(24 h SBP)以及24 h平均舒张压(24 h DBP)可能是其关键的独立危险因素。结论原发性高血压患者昼夜血压节律异常与尿微量白蛋白的关系密切,其中dSBP、24 h SBP以及24 h DBP可能是其关键的独立危险因素。

Objective To study relationship of abnormality of circadian blood pressure （BP） and microalbuminuria of patients with essential hypertension.Methods 188 patients with essential hypertension were divided into group A （non-dipper type group） and group B （ dipper type group） according to nocturnal reduction rate.Meanwhile,30 healthy people were selected as the control group （group C）.Then, general data of patients, 24 h ambulatory blood pressure, fasting blood-glucose, cholesterol and micrealbuminuria were recorded and compared.And relationship of abnormality of circadian BP and microalbu- minutia was observed.Results Urine microalbumin in group A was significantly higher than that in group B and Group C（P 〈0. 01 ）.The urine microalbumin in group A was affected by many factors, among which day mean systolic blood pressure （dSBP） ,24 h mean systolic blood pressure （24 h SBP） and mean diastolic blood pressure （24 h DBP） may be the key in- dependent risk factors.Conclusion Circadian change of blood pressure in patients with essential hypertension is closely related to miemalbuminuria,and dSBP ,24 h SBP and 24 h DBP may be the key independent risk factors of micrealbuminuria.