原发性高血压患者尿微量白蛋白/肌酐与尿钠、尿钾的相关性

Relationship between urinary albumin to creatinine ratio and urine sodium as well as urine potassium in patients with essential hypertension

目的探讨原发性高血压患者尿微量白蛋白/肌酐(U-ALB/CR)与尿电解质之间的关系。方法通过回顾新疆医科大学第一附属医院高血压科2013年1月至2015年2月住院原发性高血压患者(1108例)入院的血脂、血电解质、24 h尿电解质及U-ALB/CR等检查,研究年龄、尿钾、尿钠与U-ALB/CR之间的相关性。结果U-ALB/CR正常组(U-ALB/CR<3.0g/mol,939例)和异常组(U-ALB/CR≥3.0g/mol,169例)的年龄、病程、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血钠、空腹血糖、24h尿钠等差异无统计学意义(均P>0.05)。U-ALB/CR异常组体质量指数(BMI)、收缩压、舒张压、血钠/血钾和尿钠/尿钾较U-ALB/CR正常组高[分别为26.4(24.0~28.6)比25.3(23.5~27.6)kg/m^2,146(132~170)比140(130~151)mm Hg,93(81~104)比88(79~95)mm Hg,39.0(36.1~41.7)比38.3(35.8~40.5)和3.6(2.5~5.2)比3.1(2.5~3.9);均P<0.05];血钾、24h尿钾较U-ALB/CR正常组低(均P<0.05)。多因素Logistic回归分析结果显示,收缩压、舒张压、BMI和尿钠/尿钾为U-ALB/CR增高的危险因素[OR(95% CI)分别为1.345(1.051~1.721),1.410(1.117~1.778),1.061(1.011~1.113),1.262(1.145~1.391);均P<0.05];尿钾为保护性因素[OR(95% CI)为0.987(0.978~0.996),P<0.05]。结论原发性高血压患者U-ALB/CR与血压、尿钠/尿钾及BMI相关。

Objective To investigate the relationship between urinary albumin to creatinine ratio（U-ALB/CR）and urinary electrolytes in patients with essential hypertension. Methods The blood lipids,blood electrolytes,24-hour urine electrolytes and U-ALB/CR of 1108 hypertensives were retrospectively collected in the First Affiliated Hospital of Xinjiang Medical University from January 2013 to February 2015. And the correlations between age,urine potassium,urine sodium and U-ALB/CR were analyzed. Results There was no significant difference in age,course of hypertension,cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,blood sodium,fasting blood glucose and 24-hour urine sodium between normal U-ALB/CR（3.0 g/mol,939 cases）and abnormal U-ALB/CR groups（≥3.0 g/mol,169 cases）. Compared with normal U-ALB/CR subjects,patients with abnormal U-ALB/CR showed higher body mass index[BMI,26.4（24.0-28.6）vs 25.3（23.5-27.6）kg/m^2],systolic blood pressure[SBP,146（132-170）vs 140（130-151）mm Hg],diastolic blood pressure[DBP,93（81-104）vs 88（79-95）mm Hg],serum sodium/potassium [39.0（36.1-41.7）vs 38.3（35.8-40.5）]and urine sodium/potassium [3.6（2.5-5.2）vs 3.1（2.5-3.9）;all P0.05];while lower serum potassium and urine potassium（both P0.05）. Multivariate Logistic regression analysis indicated that SBP（OR 1.345,95% CI 1.051-1.721）,DBP（OR 1.410,95% CI 1.117-1.778）,BMI（OR 1.061,95% CI 1.011-1.113）and urine sodium/urine potassium（OR 1.262,95% CI 1.145-1.391）were risk factors of U-ALB/CR（all P0.05）,while urine potassium was the protective factor（OR 0.987,95% CI 0.978-0.996,P0.05）. Conclusion U-ALB/CR was associated with blood pressure,BMI and the ratio of urine sodium to urine potassium in patients with essential hypertension.