老年高血压患者尿白蛋白/尿肌酐及颈动脉斑块与心-踝血管指数之间的关系

Relationship between urinary albumin/urine creatinine, carotid artery plaque and cardio-ankle vascular index in elderly hypertension patients

目的探讨老年高血压患者尿白蛋白/尿肌酐及颈动脉斑块与心-踝血管指数之间的关系。方法纳入119例行心-踝血管指数(CAVI)检测并具有血脂、血糖、颈动脉斑块等指标的老年住院患者,根据是否高血压及尿白蛋白/尿肌酐是否升高,分为对照组(无高血压且尿白蛋白/尿肌酐<30mg/g,n=16)、单纯高血压组(高血压且尿白蛋白/尿肌酐<30mg/g,n=73)及早期高血压肾病组(高血压且尿白蛋白/尿肌酐≥30mg/g但≤300mg/g,n=30)。根据CAVI是否升高分为CAVI升高组(CAVI≥9.0m/s)及CAVI正常组(CAVI<9.0m/s)。结果 (1)早期高血压肾病组24h尿蛋白、尿微量白蛋白/尿肌酐、CAVI高于对照组及单纯高血压组。Pearson相关性分析显示:CAVI与尿微量白蛋白/尿肌酐呈直线相关(P<0.05)。(2)颈动脉斑块发生率:对照组(37.50%)<单纯高血压组(63.01%)<早期高血压肾病组(80.00%)(P<0.05)。CAVI升高组颈动脉斑块发生率高于CAVI正常组(P<0.05)。Spearman相关性分析提示CAVI升高的高血压老年患者颈动脉斑块形成风险更高(P<0.05)。

Objective To investigate the relationship between the urine albumin/urine creatinine ratio （ACR）, carotid artery plaque and cardio-ankle vascular index （CAVI） in elderly hypertension patients. Methods 119 elderly hospitalized patients who had CAVI, blood glucose, blood lipid and carotid artery plaque data were enrolled. According to the blood pressure and urine ACR level,they were divided into control group （without hypertension and urine ACR 〈 30mg/g,n=16）, hypertension group （with hypertension and urine ACR 〈 30mg/g,n=73） and early hypertensive nephropathy group （with hypertension and urine ACR 30-300mg/g,n=30）. According to the CAV1 level, they were divided into high CAV1 group （CAVI I〉 9.0m/s） and normal CAVI group （CAVI ~ 9m/s）. Results （1）24h urinary protein, urine ACR, and CAVI were higher in early hypertensive nephropathy group than those in the control group and hypertension group. Pearson correlation analysis showed that CAVl was linearly related to urine ACR （P 〈 0.05）.（2）The incidence of carotid plaques was higher in early hypertensive nephropathy group than that in hypertension group （80.00% versus 63.01%） （P 〈 0.05）. Similarly, the incidence of carotid plaques was higher in hypertensive nephropathy group than that in control group （63.01% versus 37.50%）（P 〈 0.05）.The incidence of carotid artery plaque was higher in the high CAVI group than that in normal CAVI group （P 〈 O.05）.Spearman correlation analysis showed that CAVI increased the risk of carotid plaque formation in elderly hypertension patients （P 〈 0.05）. Conclusion CAVI is associated with the urine ACR and carotid atherosclerosis plaque in elderly hypertension patients.