中青年难治性高血压患者血压、桡动脉血管超声与尿微量白蛋白/肌酐比值的相关性分析

An analysis of correlation among blood pressure,radial artery ultrasonography and ratio of urine microalbumin to creatinine in young and middle-aged patients with resistant hypertension

目的分析中青年难治性高血压(RH)患者的血压、桡动脉血管超声与尿微量白蛋白/肌酐比值(UACR)的相关性。方法 100例高血压患者分为RH组和可控性高血压(CH)组,每组50例,分析两组患者的血压值、UACR和桡动脉血管超声情况。结果 RH组UACR高于CH组(5.81±3.25vs.1.68±1.05)(P<0.05)。两组SBP、DBP、平均血压、壁腔比、平均剪切应力和周向壁应力比较差异均有统计学意义(P<0.05)。RH患者动脉壁腔比与管壁横截面积呈负相关(r=-0.312,P<0.05),而与周向壁应力、UACR呈正相关(r=0.874、0.425,P<0.05)。多元线性回归分析结果显示,RH患者桡动脉壁腔比的独立影响因素有SBP、DBP、UACR和周向壁应力(P<0.05)。结论与CH患者相比,中青年RH患者小动脉重构程度高,靶器官肾损伤更加严重。

Objective To analyze the correlation among blood pressure, radial artery ultrasonography and the ratio of urine microalbumin to creatinine（UACR） in young and middle-aged patients with resistant hypertension（RH）. Methods A total of 100 patients with hypertension was equally divided into two groups of RH and CH（with controllable hypertension）. The blood pressure, UACR and radial artery uhrasonography were recorded and analyzed. Results The UACR in group RH was higher than that in group CH （5.81 ±3.25 vs. 1.68 ± 1.05） （P〈0.05）. There were significant differences in SBP, DBP, mean blood pressure, the ratio of wall thickness to size, mean shear stress and circumferential wall stress between groups of RH and CH（P〈0. 05）. The ratio of arterial wall thickness to size was negatively correlated with cross-sectional area of wall （r=-0. 312, P〈0.05） and positively correlated to circumferential wall stress and UACR in group RH（r=0. 874 and 0. 425, P〈0.05）. The multiple linear regression analysis showed that SBP, DBP, UACR and circumferential wall stress were the independent factors influencing the ratio of arterial wall thickness to size in group RH（P〈0. 05）. Conclusion Compared with CH patients,the degree of small arterial remodeling is higher and the renal injury is more serious in RH patients.