原发性高血压患者24 h尿钠钾比值与中心动脉压相关指标之间的关系

Relationship between 24-hour urinary sodium-potassium ratio and central arterial pressure related indicators in patients with essential hypertension

目的:探讨原发性高血压患者24 h尿钠钾比与中心动脉压相关指标之间的关系。方法:选取2016年1月—2019年12月在新疆医科大学第一附属医院高血压科就诊并确诊的原发性高血压患者1053例。测定其24 h尿电解质并计算出24 h尿钠钾比。根据24 h尿钠钾比三分位数,将患者分成T1组(24 h尿钠钾比≤3.27,349例)、T2组(3.27<24 h尿钠钾比<4.89,356例)、T3组(24 h尿钠钾比≥4.89,348例)。比较各组一般临床资料、尿电解质、中心动脉压等相关指标,探讨24 h尿钠钾比与中心动脉压的相关性及其影响因素。结果:T3组24 h尿钠显著高于T2与T1组,24 h尿钾显著低于T2与T1组(均P<0.05);T3组中心动脉收缩压(CSP)、中心动脉脉压(CPP)及校正心率为75次的反射波增强指数(AIX75)均显著高于T2与T1组(均P<0.05)。Pearson相关性分析显示,24 h尿钠钾比与CSP、CPP、AIX75均呈正相关(r=0.227、0.229、r=0.859,均P<0.01)。多因素Logistic回归分析显示,24 h尿钠钾比升高是CSP[HR(95%CI):1.074(1.017~1.133);P<0.05]与AIX75[HR(95%CI):1.664(1.508~1.837);P<0.01]的独立危险因素。结论:在原发性高血压患者中,24 h尿钠钾比与CSP、CPP、AIX75呈正相关,是CSP、AIX75升高的独立危险因素,与AIX75有更强的相关性,可用于评估中心动脉血压及血管结构与功能情况。

Objective:To investigate the relationship between 24-hour urinary sodium-potassium ratio and central arterial pressure related indicators in patients with essential hypertension.Methods:A total of 1053 patients with essential hypertension diagnosed in the Department of Hypertension,the First Affiliated Hospital of Xinjiang Medical University from January 2016 to December 2019 were selected.The 24-hour urinary sodium-potassium ratio was measured.According to the tri-sectional quantiles of 24-hour urinary sodium-potassium ratio,all patients were divided into three groups:T1 group(24-hour urinary sodium potassium ratio≤3.27,n=349),T2 group(3.27<24-hour urinary sodium potassium ratio<4.89,n=356),T3 group(24-hour urinary sodium potassium ratio≥4.89,n=348).The general clinical data,urine electrolytes,and central arterial pressure related indicators among the three groups were compared.The correlation between 24-hour urinary sodium-potassium ratio and central arterial pressure and the influencing factors were investigated.Results:24-hour urinary sodium in the T3 group was significantly higher than those in the T2 and T1 group,24-hour urinary potassium was significantly lower than those in the T2 and T1 group(all P<0.05);CSP,CPP and AIX75 in the T3 group were significantly higher than those inthe T2 and T1 group(all P<0.05).Pearson correlation analysis showed that there was a positive correlation between 24-hour sodium-potassium ratio and CSP,CPP and AIX75(r=0.227,0.229,r=0.859,all P<0.01).Multivariate Logistic regression analysis showed that 24-hour urinary sodium-potassium ratio was an independent risk factor for CSP(OR[95%CI]:1.074[1.017-1.133];P<0.05)and AIX 75(OR[95%CI]:1.664[1.508-1.837];P<0.01).Conclusion:In patients with essential hypertension,the 24-hour sodium-potassium ratio is positively correlated with CSP,CPP and AIX75.It is an independent risk factor for the increase of CSP and AIX75 and has a stronger correlation with AIX 75,suggesting that it can be used to evaluate the central blood pressure,vascular structure,and function.