老年杓型高血压晨峰早期肾损害及Hcy、hs-CRP的检测价值

Early lesion of rentanl function in elderly patients with dipper essential hypertension and MBPS,and the value in detection of Hcy and hs-CRP

目的探讨老年杓型高血压患者血压晨峰(MBPS)现象早期肾功能损害及同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)在高血压早期肾功能损害中的检测价值。方法168例老年高血压杓型患者,依据动态血压结果有无MBPS现象分为晨峰组(n=73)和非晨峰组(n=95),均进行胱抑素C(Cys C)、尿微量白蛋白(U-mA lb)、尿转铁蛋白(UTRF)、Hcy、hs-CRP监测,并常规监测血肌酐(SCr)、血尿素氮(BUN)、血糖(GLU)、胆固醇(TCH)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),分析两组间Cys C、Hcy、hs-CRP值和U-mA lb、U-TRF阳性率差异。结果两组患者SCr、BUN、GLU、TCH、TG、HDL-C、LDL-C比较差异均无统计学意义;晨峰组MBPS变异幅度、Cys C值、Hcy值、hs-CRP值均显著高于非晨峰组(P=0.000);晨峰组U-mA lb阳性率高于非晨峰组(χ2=18.014,P=0.000);晨峰组U-TRF阳性率高于非晨峰组(χ2=19.694,P=0.000)。结论老年杓型高血压MBPS现象对Cys C、U-mA lb、U-TRF、Hcy、hs-CRP有显著影响,MBPS较非MBPS更容易引起早期肾功能损害,Hcy、hs-CRP对高血压早期肾功能损害有检测价值。

Objective To find out early lesion of rentanl function in elderly patients with dipper essential hyperten-sion and morning blood pressure surge（ MBPS） , and to find out the value of homocysteine（ Hcy） with high-sensitiv-ity C reactive protein （ hs-CRP） in detecting early lesion of rentanl function in hypertensive patients. Methods Totally 168 elderly paritents with dipper essential hypertension were divided into MBPS group（ observation group, n=73） and non-MBPS group （control group, n=95） according to the accompanying MBPS or not. The cystatin C （ Cys C） , urinary microcalbumin （ U-mAlb） ,urinary transferring（ U-TRF） ,Hcy, hs-CRP,serum creatinine（ SCr） , blood urea nitrogen（BUN）, blood glucose（Glu）,cholesterol（TCH）,triglyceride（TG）, high density lipoprotein cholesterol（ HDL-C） and low density lipoprotein cholesterol（ LDL-C） were tested. The differences in Cys C, Hcy, hs-CRP, the U-mAlb positive incidence and the U-TRF positive incidence between the two groups were analyzed. Results There were no statistical concernments in SCr, BUN, GLu, TCH, TG,HDL-C,and LDL-C between the two groups. The amplitude of variation in morning systolic pressure peak was higher in MBPS group than in non-MBPS group（P=0. 000）. The obvious varieties in the Cys C, Hcy,and hs-CRP were higher in MBPS group than in non-MBPS group （ P=0. 000 ） . The U-mAlb positive incidence was higher in MBPS group than in non-MBPS group（χ^2 =18. 014,P =0. 000）. The U-TRF positive incidence was higher in MBPS group than in non-MBPS group（χ^2 =19. 694,P=0. 000）. Conclusion MBPS has a great effect on Cys C,U-mAlb,U-TRF,Hcy and hs-CRP. MBPS is apt to cause early lesion of rental function in elderly patients with dipper essential hypertension. And Hcy and hs-CRP can be used to diagnose the early renal insufficiency.