H型高血压患者血尿酸与24 h血压变异性、血浆卧位肾素活性的关系研究

Relationship between serum uric acid and 24-hour blood pressure variability,supine plasma renin activity in H-type hypertension

目的 研究H型高血压患者血尿酸与24 h血压变异性（BPV）（收缩压、舒张压）、血浆卧位肾素活性之间的关系.方法 选取原发性高血压患者248例,按照血同型半胱氨酸（Hcy）水平分为四组：H0（对照组）组 40例（Hcy〈10.0 μmol/L）,H1组 85例（10 μmol/L ≤Hcy〈15.0 μmol/L）,H2组 72 例（15 μmol/L≤Hcy〈20.0 μmol/L）,H3 组51例（≥20 μmol/L）.分别测定每位患者的血尿酸水平,血浆卧位肾素活性水平,分别测定24 h动态血压,计算24 h收缩压及舒张压标准差（SD）,通过标准差评估BPV,并比较四组患者24 h BPV（收缩压和舒张压）,血浆卧位肾素水平,探究H型高血压患者血尿酸水平与24 h血压变异性、血浆卧位肾素活性之间的关系.结果 四组高血压患者随着血同型半胱氨酸水平增加（H3组〉H2组〉H1组〉H0组）,血尿酸水平增高,患者24 h收缩压、舒张压BPV亦升高,血浆卧位肾素活性亦升高,组间比较差异有统计学意义（P〈O.05）.相关性分析提示血尿酸水平与24 h BPV（收缩压、舒张压）之间存在相关性（相关系数分别为r=0.259,r=0.234）.血尿酸水平与血浆卧位肾素水平之间存在相关性（相关系数为r=0.240）.结论 H型高血压患者血尿酸水平与24 h血压变异性、血卧位肾素活性呈正相关,血尿酸,24 h SSD,24 h DSD、血浆卧位肾素活性是H型高血压的独立危险因素,我们应该在关注血压水平的同时,关注血同型半胱氨酸,血尿酸,减小血压变异性,降低血浆卧位肾素活性,从而更好的降低其并发症的发生率.

Objective To investigate the relationship between serum uric acid and 24 h BPV（systolic and diastolic）, supine renin activity in H-type hypertension.Methods A total of 248 essential hypertensive patients were divided into four groups according to serum homcoysteine（Hcy）, group H0 with 40 cases （Hcy〈10.0 μmol/L）, group H1 with 85 cases（10 μmol/L ≤Hcy〈15.0 μmol/L）,group H2 with 72 cases（ 15 μmol/L≤Hcy〈20.0 μmol/L）, group H3 with 51 cases（≥20 μmol/L）.The 24 hours ambulatory blood pressure, blood uric acid levels and supine renin activity was observed.Results The higher the homocysteine level, the higher the uric acid, and the higher the 24h-BPV, the higher the supine renin activity.The differences were significant（P〈0.05）.Correlation analysis： blood uric acid level was correlated with 24-hour blood pressure variability （systolic pressure, diastolic blood pressure） （correlation coefficient r=0.259, r=0.234, respectively）.Blood uric acid level was correlated wood supine renin activity （correlation coefficient r=0.240）.Conclusions Blood uric acid level is positively correlated with 24-hour BPV, supine renin activity in H-type hypertensive patients, blood uric acid, 24 h SSD, 24 h DSD, supine renin activity are independent risk factors for H-type hypertension, we should also pay attention to serum homocysteine, uric acid, blood pressure variability and supine renin activity, so as to reduce the incidence of its complications.