丝氨酸蛋白酶抑制因子对原发性高血压早期肾损害的预测价值分析

Exploring the value of serum vaspin levels for the prediction of early renal damage in essential hypertension patients

目的探讨原发性高血压患者血清丝氨酸蛋白酶抑制因子（Vaspin）水平对早期。肾损害程度的预测价值。方法将81例原发性高血压患者按照有无肾脏损害分为两组，尿微量白蛋白／尿肌酐（UACR）〈2mg／mmo]的40例患者为高血压无肾损害组，UACR≥2mg／mmol的41例患者为高血压。肾损害组，以同期来我院体检且无高血压者38例作为对照组，测定空腹血糖、血脂等生化指标，观察各组问血清Vaspin水平、UACR的差异，分析Vaspin与血压及UACR的相关性。结果高血压无肾损害组、高血压肾损害组UACR、Vaspin、超敏C反应蛋白（hs-CRP）和血脂与对照组比较差异均有统计学意义（P〈0．01）。高血压肾损害组UACR明显高于高血压无肾损害组（P〈0．01），Vaspin明显低于高血压无肾损害组（P〈0．01）。相关分析表明，Vaspin与收缩压、舒张压及UACR呈负相关（r=-0．409、-0．596、-0．306，P〈0．01）；UACR与收缩压、舒张压呈正相关（r=0．281、0．419，P〈0．01），与Vaspin呈负相关（r=-0．306，P〈0．01）。结论高血压患者血清Vaspin水平与血压及UACR密切相关，可作为血压升高及高血压早期肾损害的预测指标。

Objective To investigate the predictive role of serum vaspin level in early kidney injury in essential hypertensive patients. Methods 81 subjects with essential hypertension were divided into 2 groups according to the presence or absence of kidney injury, which included 40 individuals without kidney injury who had urine albumin and creatine ratio （UCAR） 〈 2mg/mmol and 41 patients with kidney disease who had UCAR ≥ 2mg/mmol. At the same time, 38 healthy subjects recruited from physical examination center in our hospital served as control group. Serum glucose and lipid levels were measured by Hitachi 7600 automatic biochemical analyzer while serum vaspin levels and UACR among groups were compared. The correlation of serum vaspin concentration with blood pressure and UACR were explored. Results Compared with control group, UACR, vaspin, high sensitivity C-reactive protein （hsCRP） and lipid levels were significantly different in essential hypertension with or without kidney disease groups （ P 〉 0.01 ）. UACR was markedly higher （ P 〉 0.01 ） and vaspin level was obviously lower（ P 〉 0.01 ） in hypertensive individuals with kidney disease than those without kidney disease. In correlation analyses, vaspin levels were negatively associated with systolic blood pressure , diastolic blood pressure and UACR （ r = - 0. 409, - 0. 596, - 0. 306, P 〈 0.01 ）. Whereas, UACR positively correlated with systolic and diastolic blood pressure（ r = 0. 281,0. 419, P 〈 0.01 ） and negatively with vaspin levels （ r = - 0. 306, P 〈 0.01 ）. Conclusion Serum vaspin levels are closely associated with blood pressure and UACR in hypertensive patients, which could be an index of high blood pressure and a predictor of early renal damage in essential hypertension.