高血压患者尿微量白蛋白肌酐比值与中心动脉压的相关性

Correlation between urinary albuminto-creatinine ratio and central arterial pressure in patients with essential hypertension

目的探讨高血压患者尿微量白蛋白肌酐比值(ACR)与中心动脉压(CAP)的相关性。方法采集了2012年1月至2016年12月在新医大一附院心脏中心高血压科住院的患者673例。根据测定的随机ACR分为两组,即ACR正常组(ACR <30 mg/g,n=485)和ACR异常组(ACR≥30 mg/g,n=188)。收集这些患者的一般临床资料。运用Sphygmocor脉搏波分析系统测定中心动脉压及其相关指标:反射波增强指数(AIX)、中心动脉收缩压(CSP)、中心动脉舒张压(CDP)、脉压(CPP)、增强压(AP),分析上述指标与ACR的相关性和影响因素。结果两组患者的收缩压、舒张压、脉压差、总胆固醇、高密度脂蛋白、载脂蛋白B、CSP、CDP、CPP、AP水平比较,差异均有统计学意义(P <0.05)。Pearson相关性分析显示,ACR与AIX、CSP、CDP、CPP、AP、收缩压、舒张压、空腹血糖、总胆固醇、尿素氮呈正相关(r=0.075,P <0.05;r=0.290,P <0.01;r=0.078,P <0.05;r=0.116,P <0.01;r=0.142,P <0.01;r=0.123,P <0.01;r=0.110,P <0.01;r=0.100,P <0.01;r=0.077,P <0.05;r=0.086,P <0.05)。多元逐步回归分析显示,CSP、AP、收缩压进入回归方程。结论 CSP、AP、收缩压是ACR的危险因素,其升高可导致ACR增高。

Objective To investigate the correlation between urinary albuminto-creatinine ratio and cen-tral arterial pressure in patients with essential hypertension(EP).Methods A total of 673 EP patients were divid-ed into the normal ACR group(ACR<30 mg/g,n=485)and the abnormal group(ACR≥30 mg/g,n=188),the clinical data of all patients were collected,Sphygmocor pulse wave analysis system was used to determine cen-tral artery-related indicators,such as central systolic pressure(CSP),central diastolic pressure(CDP),central pulse pressure(CPP),augmentation pressure(AP)and the reflected wave augmentation index.The correlation among ACR and influencing factors were analyzed.Results There were significant differences in SBP,DBP,CPP,TC,HDL-C,apolipoprotein B,CSP,CDP,CPP,AP and creatinine level between 2 groups(P<0.05,re-spectively).Pearson correlation analysis results showed that ACR was positively correlated with AIX,CSP,CDP,CPP,AP,SBP,DBP,fasting blood-glucose,TC and urea nitrogen(r=0.075,P<0.05;r=0.290,P<0.01;r=0.078,P<0.05;r=0.116,P<0.01;r=0.142,P<0.01;r=0.123,P<0.01;r=0.110,P<0.01;r=0.100,P<0.01;r=0.077,P<0.05;r=0.086,P<0.05).The multiple regression analysis revealed that CSP,AP and SBP could entere into the regression equation.Conclusion CSP,AP,SBP and risk factors of ACR can lead to the elevated ACR when they increase.