高血压病人尿微量清蛋白与血清炎性因子的关系

RELATIONSHIP BETWEEN MICROALBUMINURIA AND SERUM INFLAMMATORY CYTOKINES IN PATIENTS WITH HYPERTENSION

目的探讨原发性高血压病人尿微量清蛋白（MAU）与血清白细胞介素-6（IL-6）、内皮素-1（ET-1）、一氧化氮（NO）水平的变化及其关系。方法原发性高血压病人132例,其中MAU≥30mg/L者（MAU阳性组）47例,MAU〈30mg/L者（MAU阴性组）85例,检测其血生化及IL-6、ET-1、NO水平,并以50名健康查体者作为正常对照组。结果 MAU阳性组血IL-6、ET-1、收缩压水平均明显高于MAU阴性组及正常对照组,差异有显著性（F=284~337,P〈0.05）。MAU阳性组血NO水平低于MAU阴性组及正常对照组,差异有显著性（F=239,P〈0.05）。不同血压分级原发性高血压病人MAU、IL-6、ET-1、NO水平比较,差异有显著性（F=238~325,P〈0.05）。多元线性回归分析显示,IL-6、ET-1、收缩压与MAU呈正相关（B=0.206~0.594,P〈0.05）,NO与MAU呈负相关（B=-0.380,P〈0.05）。结论高血压合并MAU病人体内炎症反应明显增强,冠心病发病风险增加。

Objective To investigate the association of microalbuminuria（MAU）with interleukin-6（IL-6）,endothelin-1（ET-1）,and nitric oxide（NO）in patients with essential hypertension（EH）and explore their changes. Methods This study consisted of 132 EH patients,of whom,47 in MAU-positive group（MAU≥30mg/L）,and 85 in MAU-negative group（MAU30mg/L）.Their blood chemistry and serum IL-6,ET-1and NO were detected,and 50 healthy subjects served as normal controls.Results The serum levels of IL-6,ET-1,and systolic pressure of patients in MAU-positive group were obviously higher than that of patients in the MAU-negative group,the difference was statistically significant（F=284-337,P〈0.05）.The serum NO level in MAU-positive group was lower than that in the MAU-negative group and the control group,the difference being significant（F=239,P〈0.05）.The difference in MAU,IL-6,ET-1and NO levels among the patients with different blood pressure grading was significant（F=238-325,P〈0.05）.Multiple regression analysis showed that the IL-6,ET-1,and systolic pressure were positively correlated with MAU（B=0.206-0.594,P〈0.05）,and NO was negatively correlated with MAU（B=-0.380,P〈0.05）. Conclusion In vivo inflammatory response is significantly enhanced in hypertensive patients complicated with microalbuminuria and the risk of coronary artery heart attack increases.