尿检4项指标对判断老年原发性高血压患者肾脏有无早期损害及其程度的意义

The significance of the four indicators of urine test in determining whether there is early renal damage and the degree of damage in elderly patients with essential hypertension

目的探讨对不同分级和病程的老年原发性高血压患者进行尿检4项指标水平监测的临床意义。方法选取玉环市人民医院2018年6-12月263例门诊送尿检的老年原发性高血压患者,按高血压分级分成1级组(94例)、2级组(102例)、3级组(67例)3组,按高血压病程分成<10年组(96例)、≥10~<20年组(91例)、≥20年组(76例)3组,比较不同组间24小时尿蛋白定量、尿微量白蛋白、尿β2微球蛋白和N-乙酰-β-D氨基葡萄糖苷酶(以下简称尿检4项指标)水平。结果不同高血压分级组(F=5.422、126.450、24.756、10.325)、不同病程组(F=6.452、36.750、33.911、7.180)的老年原发性高血压患者尿检4项指标水平比较,差异均有统计学意义(均P<0.05)。2级组、3级组的尿检4项指标水平均高于1级组(均P<0.05);3级组高于2级组(均P<0.05)。病程≥10~<20年组、≥20年组的尿检4项指标水平均高于病程<10年组(均P<0.05);病程≥20年组高于病程≥10~<20年组(均P<0.05)。结论老年原发性高血压患者尿检4项指标水平均随高血压分级的升高而升高、随病程增长而升高,即高血压分级越高、病程越长,其尿检4项指标的水平越高,提示临床需重视对病程长、病情重的老年原发性高血压患者进行尿检4项指标水平的监测。

Objective To explore the clinical significance of monitoring the four indicators of urine test in elderly patients with essential hypertension with different grades and disease courses.Methods From June to December 2018,263 elderly patients with essential hypertension were included in our hospital’s outpatient department for routine urine examination.According to the classification of hypertension,the patients were divided into three groups:grade 1(94 cases),grade 2(102 cases)and grade 3(67 cases).To compare the levels of four commonly used indexes in urine test of elderly patients with hypertension in different grading groups,including 24 h urinary protein quantity,urinary microalbumin,urinaryβ2 microglobulin and N-acetyl-β-d-glucosaminidase.Results The comparison of urine test levels of elderly patients with essential hypertension in different hypertension grading groups(F=6.452,36.750,33.911 and 7.180)and different course groups(F=6.452,36.750,33.911 and 7.180)showed statistically significant differences(all P<0.05).The level of urine test in grade 2 group and grade 3 group was higher than that in grade 1 group(P<0.05).The grade 3 group was higher than the grade 2 group(P<0.05).The levels of the four indicators of urine test in the group with disease course of 10(including)-20 years and≥20 years were higher than those in the group with disease course<10 years(all P<0.05).The course of disease≥20 years was higher than that of 10-20 years(P<0.05).Conclusion The elderly patients with hypertension have different grades and course of hypertension.The higher the score of hypertension and the longer the course of hypertension,the higher the level of the four commonly used indexes and the more serious the condition.It is suggested that clinical attention should be paid to the monitoring of four indicators commonly used in urine test for elderly hypertensive patients with long course of disease and severe condition.