青年原发性高血压伴微量蛋白尿与动脉弹性功能的相关性

Correlation between young essential hypertension with concomitant urinary micro albuminuria and arterial elastic function

目的探讨青年原发性高血压(EH)患者及伴微量蛋白尿时对动脉弹性功能的影响。方法采用全自动动脉硬化仪检测高血压患者和正常对照组的颈-股动脉脉搏波传导速度(CF-PWV)、肱踝脉搏波传导速度(BaPWV)、中心动脉收缩压(CSP)和反射波增强指数(AI)。所有患者均未接受药物治疗,收集患者临床资料和尿微量蛋白/肌酐(UACR)结果。按血压及UACR进行分组:正常对照组40例、青年EH组44例,青年EH伴微量蛋白尿组32例。结果青年EH伴微量蛋白尿组体质指数(BMI)、三酰甘油(TG)高于青年EH组和正常对照组(P<0.05),而年龄、性别、血糖、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)三组比较差异无显著性(P>0.05)。与青年EH组比较,正常对照组CSP、AI降低,而高血压合并微量蛋白尿组CF-PWV、CSP、AI显著增高。Pearson相关性分析显示,在青年EH组,CSP、AI与收缩压成正相关,BaPWV与舒张压成正相关(P<0.05)。而青年EH伴微量蛋白尿组,CSP、CF-PWV与收缩压和舒张压成正相关,CSP、CF-PWV、AI与UACR成正相关(P<0.05)。结论CSP、AI可预测青年EH患者早期动脉弹性功能损伤程度,CF-PWV在一定程度上可以反映青年高血压患者的肾损伤程度。

Objective To investigate the influence of essential hypertension(EH)with concomitant urinary micro albuminuria(U-mAlb)on arterial elastic function in young patients.Methods The levels of carotid-femoral pulse wave velocity(cfPWV),brachial-ankle pulse wave velocity(baPWV),central aortic systolic blood pressure(CSP)and augmentation index(AI)were detected by using automatic atherosclerosis detector in EH patients and healthy persons.All patients were treated with drugs,and clinical data and detecting results of urine micro albumin/creatinine(UACR)were collected.The patients were divided,according to blood pressure and UACR,into EH group(n=44)and EH+UmAlb group(n=32).Meanwhile the controls without hypertension were chosen into normal control group(n=40).Results The levels of BMI and TG were higher in EH+U-mAlb group than those in EH group and normal control group(P<0.05),and difference in age,sex,blood sugar,TC,HDL-C and LDL-C had no significance among 3 groups(P>0.05).Compared with EH group,the levels of CSP and AI decreased in normal control group,and levels of cfPWV,CSP and AI increased significantly in EH+U-mAlb group.The results of Pearson correlation analysis showed that CSP and AI were positively correlated to systolic blood pressure(SBP),and baPWV was positively correlated to diastolic blood pressure(DBP)in EH group(P<0.05).The levels of CSP and cf-PWV were positively correlated to SBP and DBP,and CSP,cfPWV and AI were positively correlated to UACR in EH+U-mAlb group(P<0.05).Conclusion The levels of CSP and AI can predict the severity of arterial elastic function damage,and cfPWV can reflect to some extent the severity of kidney injury in young patients with hypertension.