老年原发性高血压患者24 h尿钠与24 h尿微量白蛋白、左心室质量指数的相关性研究

Study on correlation of 24-h urinary sodium and 24-h urinary microalbumin with left ventricular mass index in elderly patients with essential hypertension

目的探讨老年原发性高血压患者24 h尿钠与24 h尿微量白蛋白、左心室质量指数(LVMI)之间的关系。方法选取126例老年原发性高血压患者,根据24 h尿微量白蛋白测定值将患者分为观察组(24 h尿微量白蛋白升高,≥30 mg/24 h,61例)和对照组(24 h尿微量白蛋白正常,<30 mg/24 h,65例)。两组患者均接受血压测定、尿生化检测、血生化检测、左心室质量指数测量。比较两组患者血压、尿生化、血生化、左心室质量指数,并进行相关性分析。结果观察组和对照组患者的心率、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖、血钠、血钾、收缩压(SBP)、舒张压(DBP)、肌酐比较差异无统计学意义(P>0.05)。观察组24 h尿微量白蛋白(46.6±4.5)mg/24 h、24 h尿钠(333.4±5.1)mmol/24 h、左心室质量指数(142.5±2.1)g/m2明显高于对照组的(18.1±3.2)mg/24 h、(176.3±3.6)mmol/24 h、(96.5±4.2)g/m2(P<0.05)。对照组内,24 h尿钠与SBP、左心室质量指数、年龄呈正相关(r=0.236、0.178、0.104,P<0.05),与心率、总胆固醇、LDL-C、HDL-C、血钠、血钾、肌酐、空腹血糖、DBP无明显相关性(P>0.05)。观察组内,24 h尿钠与24 h尿微量白蛋白、肌酐、SBP、左心室质量指数、DBP、年龄呈正相关(r=0.106、0.038、0.148、0.112、0.134、0.201,P<0.05),与心率、总胆固醇、LDL-C、HDL-C、血钠、血钾、空腹血糖无明显相关性(P>0.05)。结论老年原发性高血压患者24 h尿钠与24 h尿微量白蛋白、左心室质量指数呈正相关,24 h尿钠能早期反映左心室质量指数变化。

Objective To explore the correlation of 24-h urinary sodium and 24-h urinary microalbumin with left ventricular mass index(LVMI)in elderly patients with essential hypertension.Methods 126 elderly patients with essential hypertension were selected,and the patients were divided into an observation group(with elevated 24-h urinary microalbumin,≥30 mg/24 h,61 cases)and a control group(with normal 24-h urinary microalbumin,<30 mg/24 h,65 cases)according to the 24-h urinary microalbumin.Patients in both groups received blood pressure measurement,urine biochemistry test,blood biochemistry test,and left ventricular mass index measurement.Blood pressure,urine biochemistry,blood biochemistry,and left ventricular mass index were compared in both groups,and correlation analysis was performed.Results There was no statistically significant difference in terms of heart rate,total cholesterol,low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose,blood sodium,blood potassium,systolic blood pressure(SBP),diastolic blood pressure(DBP)and creatinine between the observation group and the control group(P>0.05).The 24-h urinary microalbumin of the observation group was(46.6±4.5)mg/24 h,the 24-h urinary sodium was(333.4±5.1)mmol/24 h and the left ventricular mass index was(142.5±2.1)g/m2,which were significantly higher than(18.1±3.2)mg/24 h,(176.3±3.6)mmol/24 h and(96.5±4.2)g/m2 in the control group(P<0.05).In the control group,24-h urinary sodium was positively correlated with SBP,left ventricular mass index,and age(r=0.236,0.178,0.104;P<0.05),and there was no significant correlation with heart rate,total cholesterol,LDL-C,HDL-C,blood sodium,blood potassium,creatinine,fasting blood glucose,and DBP(P>0.05).In the observation group,24-h urinary sodium was positively correlated with 24-h urinary microalbumin,creatinine,SBP,left ventricular mass index,DBP,and age(r=0.106,0.038,0.148,0.112,0.134,0.201;P<0.05),and there was no significant correlation with heart rate,total cholesterol,LDL-C,HDL-C,blood sodium,blood potassium,and fasting blood glucose(P>0.05).Conclusion In elderly patients with essential hypertension,24-h urinary sodium is positively correlated with 24-h urinary microalbumin and left ventricular mass index, and 24-h urinary sodium reflects early changes in left ventricular mass index.