原发性高血压患者UACR与左室重构的相关性

Correlation between UACR and left ventricular remodeling in patients with essential hypertension

目的:探讨原发性高血压(EH)患者尿微量白蛋白肌酐比值(UACR)与左室重构的相关性。方法:根据血压水平,本院心内科2019年3月至2021年3月期间收治的EH患者360例被分为高血压1级组(164例)、高血压2级组(126例)、高血压3组(60例);按照左室质量指数(LVMI)正常与否,患者被分为LVMI正常组(235例)和LVMI异常组(125例)。比较LVMI正常组和LVMI异常组一般资料和临床资料;比较高血压1~3级组之间血肌酐(SCr)、UACR、LVMI,分析上述指标间的相关性,应用多因素Logistic回归分析EH患者LVMI异常的危险因素。结果:与LVMI正常组比较,LVMI异常组年龄[(59.81±11.05)岁比(65.09±10.34)岁]、SCr[(85.48±16.59)mmol/L比(94.16±18.33)mmol/L]、UACR[(0.98±0.25)mg/g比(1.36±0.32)mg/g]均显著升高,P均=0.001。与高血压1级组比较,2级、3级组SCr[(83.28±14.66)mmol/L比(87.05±16.29)mmol/L比(95.72±17.55)mmol/L]、UACR[(0.96±0.30)mg/g比(1.15±0.38)mg/g比(1.42±0.43)mg/g]、LVMI[(96.37±18.11)g/m^(-2)比(107.29±17.64)g/m^(-2)比(122.03±19.21)g/m^(-2)]均显著升高,且3级组的显著高于2级组的,P<0.05或<0.01。Pearson相关分析显示EH患者SCr和UACR均与LVMI呈显著正相关(r=0.463,0.859,P=0.023,0.009)。多因素Logistic回归分析显示,UACR是EH患者LVMI异常的独立危险因素(OR=1.936,P=0.001)。结论:UACR可有效预测原发性高血压患者左室重构的发生,可为高血压早期心脏损害评估提供有力依据。

Objective:To explore correlation between urinary microalbumin creatinine ratio(UACR)and left ventricular remodeling in patients with essential hypertension(EH).Methods:According to blood pressure level,a total of 360 EH patients treated in our department of cardiology from Mar 2019 to Mar 2021 were divided into EH stage 1 group(n=164),EH stage 2 group(n=126)and EH stage 3 group(n=60);according to left ventricular mass index(LVMI)normal or not,patients were divided into normal LVMI group(n=235)and abnormal LVMI group(n=125).General data and clinical data were compared between normal and abnormal LVMI group;SCr,UACR and LVMI were compared among EH stage 1~3 group,and correlation among above indexes was analyzed.Multivariate Logistic regression analysis was used to analyze risk factors of abnormal LVMI in EH patients.Results:Compared with normal LVMI group,there were significant rise in age[(59.81±11.05)years vs.(65.09±10.34)years],SCr[(85.48±16.59)mmol/L vs.(94.16±18.33)mmol/L]and UACR[(0.98±0.25)mg/g vs.(1.36±0.32)mg/g]in abnormal LVMI group,P=0.001 all.Compared with EH stage 1 group,there were significant rise in SCr[(83.28±14.66)mmol/L vs.(87.05±16.29)mmol/L vs.(95.72±17.55)mmol/L],UACR[(0.96±0.30)mg/g vs.(1.15±0.38)mg/g vs.(1.42±0.43)mg/g]and LVMI[(96.37±18.11)g/m^(-2) vs.(107.29±17.64)g/m^(-2) vs.(122.03±19.21)g/m^(-2)]in stage 2 and 3 group,and those of stage 3 group were significantly higher than those of stage 2 group,P<0.05 or<0.01.Pearson correlation analysis indicated that SCr and UACR were significant positively correlated with LVMI in EH patients(r=0.463,0.859,P=0.023,0.009).Multivariate Logistic regression analysis indicated that UACR was independent risk factor for abnormal LVMI in EH patients(OR=1.936,P=0.001).Conclusion:UACR can effectively predict the occurrence of left ventricular remodeling in EH patients,and it can provide a strong basis for early assessment of cardiac damage in patients with hypertension.