原发性高血压患者脉压与尿微量白蛋白的关系

The relationship between pulse pressure and urine microalbumin in patients with essential hypertension

目的 观察原发性高血压患者脉压对肾损害的影响.方法 229例轻中度原发性高血压患者行24 h动态血压监测,按24 h平均脉压（MPP）分为EH1（24 h MPP≥60 mmHg,1 mmHg=0.133 kPa）组（128例）和EH2（24 h MPP＜ 60 mmHg）组（101例）.依据24 h尿微量白蛋白及肾功能生化测定,观察并比较患者脉压对肾功能的影响.结果 EH1组24 h平均收缩压（MSBP）、24 h MPP明显高于EH2组[（156.20±6.11） mmHg比（143.67±5.46） mmHg,（69.09±5.87） mmHg比（51.15±7.15） mmHg],EH2组24 h平均舒张压（MDBP）明显高于EH1组[（92.52±5.93）mmHg比（87.11±5.52） mmHg],差异有统计学意义（P＜0.01）.EH1组24 h尿微量白蛋白较EH2组明显增高[（104.80±24.25） mg比（91.29±24.03） mg],差异有统计学意义（P＜0.01）.24 h MPP、24 h MSBP与24 h尿微量白蛋白呈正相关（r=0.259,0.201,P＜ 0.01）,24 h MDBP与24 h尿微量白蛋白呈负相关（r=-0.180,P＜0.01）.结论 原发性高血压患者24 h MPP与高血压性肾损害密切相关.

Objective To observe the influence of pulse pressure on renal injury in patients with essential hypertension （EH）.Methods Two hundred and twenty-nine patients with mild-to-moderate EH completed 24 h ambulatory blood pressure monitoring.The patients were divided into 2 groups according to 24 h mean pulse pressure （MPP）：EH 1 （24 h MPP ≥ 60 mmHg,1 mmHg =0.133 kPa） group （128 cases） and EH2 （24 h MPP 〈 60 mmHg） group （101 cases）.According to 24 h urine microalbumin and biochemical determination of renal function,the influence of pulse pressure on kidney function was observed and compared.Results The 24 h mean systolic blood pressure （MSBP） and 24 h MPP in EH1 group were significantly higher than those in EH2 group [（156.20 ±6.11） mmHg vs.（143.67 ±5.46） mmHg,（69.09 ±5.87） mmHg vs.（51.15 ±7.15） mmHg] （P 〈0.01）,the 24 h mean diastolic blood pressure （MDBP） in EH2 group was significantly higher than that in EH1 group [（92.52 ±5.93） mmHg vs.（87.11 ± 5.52） mmHg]（P〈 0.01）.The 24 h urine microalbumin in EH1 group was significantly higher than that in EH2 group [（104.80 ± 24.25） mg vs.（91.29 ± 24.03） mg] （P 〈 0.01）.There was positive correlation between 24 h MPP,24 h MSBP and 24 h urine microalbumin （r =0.259,0.201,P 〈 0.01）,and there was negative correlation between 24 h MDBP and 24 h urine microalbumin （r =-0.180,P〈 0.01）.Conclusion The 24 h MPP is closely related with the renal injury which is caused by high blood pressure in patients with EH.