老年高血压患者尿微量白蛋白与血压变异性、单核细胞趋化蛋白-1及白介素-18的关系

Relationship between UMA and blood pressure variability,monocyte chemoattractant-1,and interleukin-18 in the elderly hypertensives patients

目的探讨老年高血压患者尿微量白蛋白(UMA)与血压变异性(BPV)、单核细胞趋化蛋白-1(MCP-1)、白介素-18(IL-18)的关系。方法选取老年高血压患者168例,所有病例均进行尿微量白蛋白(UMA)测定,并根据UMA水平将患者分为正常组(UMA﹤30 mg/L,63例)和异常组(UMA≥30 mg/L,105例);测定患者血清MCP-1和IL-18的水平;所有患者均行24 h无创动态血压监测,计算各时间段血压变异系数的(CV)数值。结果异常组UMA、IL-18、MCP-1、24 h收缩压变异系数(24h SCV)、24 h舒张压变异系数(24h DCV)、白天收缩压变异系数(d SCV)、夜间收缩压变异系数(n SCV)、空腹血糖(FBG)、入院SBP水平高于正常组;Pearson线性相关关系显示UMA与IL-18、MCP-1、24h SCV、d SCV、n SCV成正相关关系,IL-18与24h SCV、n SCV、24h DCV、d DCV成正相关关系,MCP-1与24h SCV、n SCV成正相关关系;多元逐步线性回归提示:IL-18、MCP-1、n SCV、d SCV可能为UMA危险因素,IL-18为24h SCV、d DCV的独立危险因素,MCP-1为n SCV的独立危险因素。结论 IL-18、MCP-1、BPV参与老年高血压患者早期肾损害;IL-18、MCP-1与老年高血压患者血压变异性密切相关。

Objective To investigate the relationship between urinates the micro albumin （UMA） and blood pressure variability（BPV） , monocyte ehemoattractant-1 （MCP-1） , and intedeukin-18 （IL-18） in the elderly hypertensives patients. Methods A total of 168 elderly patients with primary hypertension were divided into nor- mal group UMA[ UMA 〈 30 mg/L, n = 63 ] and abnormal group[ UMA ≥30mg/L, n = 105 ] according to the the level of albuminuria in our hospital. The level of MCP - 1 and IL - 18 were detected, and the 24 h hambulatory blood pressure monitoring were underwent and then the numerical value of CV were calculated. Results The level of UMA, IL-18, MCP-1,24hSCV,24hDCV, dSCV, nSCV, FBG and SBP of abnormal group were higher than those of normal group. The pearson correlation analysis showed that UMA was positively correlated with IL-18, MCP-1, 24hSCV, dSCV and nSCV, and IL-18 was positively correlated with 24hSCV, nSCV, 24hDCV and dDCV. MCP-1 was positively correlated with 24hSCV and nSCV. The results of Stepwise multivariate linear regression showed that IL-18, MCP-1, nSCV and dSCV was the risk factors of UMA. IL-18 was the independent risk factor of 24hSCV and dDCV. MCP-1 may be the independent risk factor of nSCV. Conclusion IL-18, MCP-1 and blood pressure variability play a role in early renal damage of elderly hypertensive patients. IL-18 and MCP-lare closely correlated with blood pressure variability.