CAJ | 학술논문

目的探讨高血压患者脉压与尿微量白蛋白(microalbuminuria)排泄量的关系.方法选取243例原发性高血压患者,按照高血压类型分为杓型(198例)和非杓型(45)两组.比较两组间性别、年龄、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平、体重指数、蛋白尿的发生率及24 h尿蛋白排泄量.结果非杓型高血压组尿蛋白阳性率为41.3%、24 h尿白蛋白排泄量为(234.6±41.4)mg,均明显高于杓型高血压组23%,(146±35)mg.收缩压、脉压与24 h尿蛋白量呈正相关,其相关系数r分别为0.478(p<0.05)、0.637(p<0.05);尤其在非杓型高血压中,脉压与24 h尿蛋白量排泄量相关系数r=0.81(p<0.05)远高于杓型(r=0.58,p<0.05).结论非杓型高血压较杓型高血压引起的肾损害害明显早于和严重于杓型高血压;抗高血压治疗亦应注意合理地控制夜间血压.
목적 탐토고혈압환자맥압여뇨미량백단백(microalbuminuria)배설량적관계.방법 선취243례원발성고혈압환자,안조고혈압류형분위표형(198례)화비표형(45)량조.비교량조간성별、년령、총담고순、감유삼지、고밀도지단백담고순화저밀도지단백담고순수평、체중지수、단백뇨적발생솔급24 h뇨단백배설량.결과 비표형고혈압조뇨단백양성솔위41.3%、24 h뇨백단백배설량위(234.6±41.4)mg,균명현고우표형고혈압조23%,(146±35)mg.수축압、맥압여24 h뇨단백량정정상관,기상관계수r분별위0.478(p<0.05)、0.637(p<0.05);우기재비표형고혈압중,맥압여24 h뇨단백량배설량상관계수r=0.81(p<0.05)원고우표형(r=0.58,p<0.05).결론 비표형고혈압교표형고혈압인기적신손해해명현조우화엄중우표형고혈압;항고혈압치료역응주의합리지공제야간혈압.
Objective To investigate the relevance between the type of blood pressure (BP) and urinary microprotion in hypertensive patients.Methods All the patients were divided into two groups by the type of blood pressure:non-dipping pattern(45 subjects,18.5%) and dipping pattern(198 subjects,81.5%).Results Patients with microalbuminuria, the level of microalbuminuria, lipid, BMI were detected by groups.Patients with microalbuminuria and urinary albumin excretion(UAE) were significantly higher in non-dippers than in dippers (41.3 versus 23%, p<0.01;234.6±41.4mg versus 146±35mg, p<0.05, respectively).UAE was correlated with PP(pulse pressure),SBP (r=0.637,0.478,respectively,for both, p<0.05),between non-dipping pattern and dipping pattern (r=0.81,0.58, respectively).Conclusion This study suggests that the non-dipping pattern of ambulatory BP can be associated with a faster and more serious progression of renal insufficiency than dipping pattern.A proper nocturnal BP control is an additional aim of antihypertensive therapy.