原发性高血压患者尿白蛋白/尿肌酐比与心踝血管指数的相关性

Association of Urinary Albumin-to-creatinine Ratio with Cardio-ankle Vascular Index in Patients with Essential Hypertension

目的研究尿微量白蛋白与动脉僵硬度之间的相关性,探讨高血压早期靶器官损害的敏感指标.方法根据蛋白尿情况将80例高血压患者分为高血压非蛋白尿组(A组,n=42)和高血压蛋白尿组(B组,n=38),另选择正常健康体检者30例作为正常对照组,测定3组研究对象收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、体质量指数(BMI)及血脂等指标;测定尿素氮(BUN)、血清肌酐(Cr)、计算肾小球滤过率(GFR);采用快速免疫比浊法测定尿白蛋白/尿肌酐比(ACR);应用VS-1000动脉硬化检测仪测定心踝血管指数(CAVI);应用彩色多普勒超声诊断仪测量颈动脉内膜中层厚度(IMT).结果与正常对照组相比,A组与B组的ACR、CAVI、颈动脉IMT均升高(P<0.05);与A组相比,B组的ACR、CAVI、颈动脉IMT均高于A组(P<0.05);ACR与CAVI、颈动脉IMT呈正相关(P<0.01).结论ACR、CAVI可用作评估原发性高血压病患者心血管疾病危险性、早期靶器官损害的敏感指标.

Objective To explore the association of microalbuminuria （MA） with arterial stiffness and sensitive indicators of early target organ damage in hypertensive patients. Methods 80 hypertensive patients were divided into two groups by their microalbuminuria （MA） ： the normal microalbuminuria group （group A, n =42） and the microalbuminuria group （group B, n = 38）, and 30 healthy people as the healthy control group （n =30） . Systolic pressure （SBP）, diastolic pressure （DBP）, fasting blood glucose （FPG）, body mass index （BMI）, serum lipid, blood urea nitrogen （BUN） , serum creatiniue （Cr） and glomerular filtration rate （GFR） were measured in all subjects. Urinary albumin-to-creatinine ratio （ACR） was measured with immunoturbidimetry; cardio-ankle vascular index （CAVI） was detected by using VS-1000 atherosclerosis detective system; carotid intima-media thickness （IMT） was measured with uhrasonography. Results Compared with the control group, ACR, CAVI and carotid IMT in groups A and B were significantly increased （P 〈 0.05） . ACR, CAVI and carotid IMT in group B were higher tha~ those in group A （P 〈 0.05） . ACR was positively related to CAVI and carotid IMT （P 〈 0.01） Conclusion ACR and CAVI are non-invasive and sensitive indicators, Which can predict early target organ damage and cardiovascular risk in hypertension.