高血压前期人群微量清蛋白尿和炎性因子的变化

The changes of microalbuminuria and inflammatory factors in patients with prehypertension

目的 观察和分析高血压前期人群微量清蛋白尿（MAU）和炎性因子的变化。方法 选取100例高血压前期患者作为病例组,根据是否合并MAU将其分为MAU组（48例）和非MAU组（52例）两个亚组,选取50例健康人作为对照组。对各组研究对象的尿清蛋白排泄率（UAER）、血清超敏C反应蛋白（hs-CRP）水平、血清肿瘤坏死因子α（TNF-α）水平、尿TNF-α水平进行检测和比较。结果 对照组、非MAU组、MAU组研究对象的UAER、血清hs-CRP水平、尿TNF-α水平依次升高（q=2.453-8.347,P〈0.05）,非MAU组与MAU组患者的血清TNF-α水平的差异无统计学意义（q=0.705,P〉0.05）且均显著高于对照组（q=4.258、6.037,P〈0.05）;Logistic多元回归分析结果显示,高血压前期患者合并MAU的发生与血清hs-CRP水平（OR=3.657）和尿TNF-α水平（OR=2.164）具有相关性（P〈0.05）而与血清TNF-α水平无相关性（P〉0.05）。结论 高血压前期患者可表现为早期肾损害和炎性因子过表达,血清hs-CRP水平和尿TNF-α水平可作为预测高血压前期合并MAU发病风险的辅助指标。

Objective To observe and analyze the changes of mlcroa]buminuria （MAU） and inflammatory factors in patients with prehypertcnsion. Methods I00 cases of patients with prehypertension were selected as the case group. According to the complication with MAU,the patients were divided into the MAU group （48 cases） and the non MAU group （52 cases）. 50 healthy persons were selected as the control group. The urinary albumin excretion rate （UAER） ,the serum high sensitivity C reactive protein （hs-CRP） level, the serum and urinary tumor necrosis factor-ix （TNF-α） level of all the objects were detected. Results UAER, the serum hs-CRP level, the urinary TNF-α level of the objects in the control group, the MAU group, and the non MAU group increased gradually （q = 2.453 - 8. 347, P 〈 0.05 ）. There was no significant difference of the serum TNF-α of the patients between the MAU group and the non MAU group （q = 0. 705, P 〉 0. 05） and both were significantly higher than that in the control group （q = 4.258,6.037, P 〈 0.05） ;The multivariate Logistic regression analysis showed that the incidence of complicated MAU in the patients with prehypertension was correlated with the serum hs-CRP level （ OR = 3. 657） and the urinary TNF-α level （OR =2. 164） （P 〈0.05） ,but had no correlation with the serum TNF-α level （P〉0.05）. Conclusions The patients with prehypertension show the early renal damage and the over-expression of inflammatory factors. The serum hs-CRP level and the urinary TNF-α level can be used as the auxiliary indexes to predict the risk of prehypertension complicated with MAU.