中青年难治性高血压患者小动脉重构与靶器官肾损伤的关系

Study on the relationship between the remodeling of small artery and injury of kidney in young and middle-aged patients with resistant hypertension

目的:初步探讨中青年难治性高血压(RH)患者外周小动脉重构与亚临床靶器官肾损害的关系。方法:入选中青年(18~65岁)RH、可控性高血压(CH)及血压正常(NT)者各60例。同时检测血压、桡动脉血管超声及尿微量白蛋白肌酐比(UACR)。结果:RH组UACR、外周收缩压(SBP)、舒张压(DBP)、平均动脉压(MBP)、壁腔比、周向壁应力及平均剪切力均较CH及NT组高(P<0.05);调整混杂因素后,在总体人群中桡动脉壁腔比与UACR、周向壁应力呈正相关,与管壁横截面积呈负相关(P<0.05);多因素线性回归分析显示,在总体人群中桡动脉壁腔比的独立影响因素为周向壁应力、DBP、SBP及UACR。结论:中青年RH患者小动脉重构程度重于CH患者,且外周小动脉重构进一步加重靶器官肾损伤。

O b jectiv e:To evaluate the relationship between the remodeling of small peripheral artery and renal injuryof subclinical target organs in young and middle-aged patients witli resistant hypertension.M eth of young and middle-aged patients(18-65years old)with R H,60cases of patients witii controlled hypertension(CH)and60cases of normotensives(NT)were selected.A ll patients were performed related examinations includingBP,right radial artery and UACR.R esu lts:UACR,SBP,DBP,MBP,Z^L,CS,and SS in patients witiiRH were higher than those in patients with CH and NT(!<0?05).After adjusting the confounding were positive relations of W/L with UACRand CS and negative relation between W/L and population(P<0.05).M ulti-factor linear regression analysis showed that CS,DBP,SBP,and UACR risl^factors for W^L in the general population(P<0.05).C on clu sion:The small artery remodeling inyoung and middle-aged patients wit!i resistant hypertension is more severe than that in controlled hypertension and itcan accelerate the injury of kidney.