血压水平与尿微量白蛋白及其他影响因素的关系

Relationship between blood pressure level and urinary micro-albumin and other influencing factors

目的探究血压水平与尿微量白蛋白、肾脏损伤情况及代谢指标的关系,为高血压防治策略的制定提供科学依据。方法采用分层多阶段随机抽样方法,抽取15岁以上重庆市潼南地区常住居民进行问卷调查、体格检查,并检测调查人群的血液和尿液样本,获取血糖、血脂和尿微量白蛋白等资料。采用SPSS 20.0软件对数据进行统计学分析。结果正常血压组、血压正常高值组、高血压组出现微量白蛋白尿者(尿微量白蛋白水平≥20 mg/L)所占比例分别为21.40%(61/285)、27.36%(110/402)和48.06%(149/310),3组间差异有统计学意义(P<0.05)。高血压患者中出现微量白蛋白尿者所占比例随着血压水平的升高而增加(P<0.05)。多重线性回归分析结果显示,收缩压随着三酰甘油和低密度脂蛋白胆固醇水平的升高而升高(P<0.05),舒张压随着三酰甘油水平的升高而升高(P<0.05)。二项logistic回归分析结果显示,尿微量白蛋白、高密度脂蛋白胆固醇、年龄、腰围是高血压的独立影响因素(P<0.05)。结论尿微量白蛋白水平与血压水平密切相关,可作为早期肾损害诊断的重要指标。尿微量白蛋白、高密度脂蛋白胆固醇、年龄、腰围与高血压发生独立相关。

Objective To explore the relationship between blood pressure level and urinary micro-albumin,kidney damage and metabolic indicators,so as to provide scientific evidence for the prevention and treatment of hypertension.Methods Using stratified multi-stage random sampling method,we selected local residents(>15 years old)in Tongnan area of Chongqing for questionnaire survey,physical examination,and the detection of blood and urine samples to obtain blood glucose,blood lipids,urinary micro-albumin,and other clinical data.The data were statistically analyzed by SPSS 20.0 software.Results The proportions of patients with microalbuminuria(urinary micro-albumin level≥20 mg/L)in the normal blood pressure group,the prehypertension group,and the hypertension group were 21.40%(61/285),27.36%(110/402)and 48.06%(149/310),respectively,and there were significant differences between the three groups(P<0.05).The proportion of patients with microalbuminuria in the hypertension patients was significantly increased with the increase of blood pressure(P<0.05).Multiple linear regression analysis showed that systolic blood pressure was significantly increased with the increase of triglyceride and low-density lipoprotein cholesterol levels(P<0.05),and diastolic blood pressure was significantly increased with the increase of triglyceride level(P<0.05).Binary logistic regression analysis showed that urinary microalbumin,high-density lipoprotein cholesterol,age and waist circumference were the influencing factors of hypertension(P<0.05).Conclusion Urinary micro-albumin level is closely related to blood pressure level,and can be used as an important indicator for the diagnosis of early renal damage diagnosis.Urinary micro-albumin,high-density lipoprotein cholesterol,age and waist circumference are independently associated with hypertension.