青年高血压患者微量白蛋白尿的相关因素分析

Related Factors on Microalbuminuria in Young Patients with Hypertension

目的本研究旨在分析青年高血压患者微量白蛋白尿(MAU)的相关因素,为临床实践提供一定参考。方法采用病例对照研究设计,以泰达国际心血管病医院高血压科2020年4月—2021年7月收治的341例青年高血压患者(18~45岁)为研究对象,根据MAU测定结果将入组患者分为对照组(单纯高血压患者)和病例组(合并MAU的高血压患者),其中249例无MAU(对照组),92例有MAU(病例组)。根据资料类型采用相应统计学方法比较两组间的临床资料,并应用二元logistic回归分析探索青年高血压患者MAU的相关因素。结果该研究人群中MAU发生率为27.0%(95%CI 22.2%~31.7%)。与对照组比较,病例组收缩压[(139±17)mm Hg vs(133±14)mm Hg]及舒张压[(87±12)mm Hg vs(83±12)mm Hg]水平更高(P均<0.05)。此外,病例组体重指数[(28.5±4.5)kg/m 2 vs(26.9±3.9)kg/m 2]、立位醛固酮[(17.2±11.3)ng/mL vs(13.8±7.5)ng/mL]、尿酸[(420.4±109.1)μmol/L vs(390.5±89.3)μmol/L]及血肌酐[(69.3±14.4)μmol/L vs(66.1±12.2)μmol/L]也显著高于对照组(P均<0.05)。多因素分析发现,收缩压、高水平的立位醛固酮及尿酸与青年高血压患者MAU的发生相关。结论收缩压、高水平的立位醛固酮及尿酸可能与青年高血压患者早期肾脏损害的发生密切相关。

Objective To study related factors on microalbuminuria(MAU)in young patients with hypertension to provide references for clinical practice.Methods It was a cross-sectional study.A total of 341 young hypertensive patients aged 18 to 45 years old who admitted in TEDA International Cardiovascular Hospital from April 2020 to July 2021 were enrolled,and classified into two groups according to whether complicated by MAU,249 of whom without MAU(control group)and 92 with MAU(case group).Clinical data were compared by corresponding statistics based on data types.Binary logistic regression was used to analyze related factors on MAU.Results The incidence of MAU in this population was 27.0%(95%CI 22.2%~31.7%).Systolic blood pressure[(139±17)mm Hg vs(133±14)mm Hg],and diastolic blood pressure[(87±12)mm Hg vs(83±12)mm Hg]were higher in case group than control group(all P<0.05).Patients in case group showed higher body mass index[(28.5±4.5)kg/m 2 vs(26.9±3.9)kg/m 2],standing aldosterone[(17.2±11.3)ng/mL vs(13.8±7.5)ng/mL],uric acid[(420.4±109.1)μmol/L vs(390.5±89.3)μmol/],and creatinine[(69.3±14.4)μmol/L vs(66.1±12.2)μmol/L]levels as compared to control group(all P<0.05).Binary logistic regression analysis showed that systolic pressure,a high level of standing aldosterone and uric acid were related to MAU in young hypertensive patients(all P<0.05).Conclusion Systolic pressure,a high level of standing aldosterone and uric acid may be closely related to early renal damage in young patients with hypertension.