中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2010年
7期
572-575
,共4页
刘士莹%袁晓华%曹肇慧%王野虹%张蕴
劉士瑩%袁曉華%曹肇慧%王野虹%張蘊
류사형%원효화%조조혜%왕야홍%장온
性格%高血压%血管紧张素Ⅱ%白蛋白尿%β2-微球蛋白
性格%高血壓%血管緊張素Ⅱ%白蛋白尿%β2-微毬蛋白
성격%고혈압%혈관긴장소Ⅱ%백단백뇨%β2-미구단백
Character%Hypertension%Angiotensin Ⅱ%Albumin uria%Beta 2 -microglobulin
目的 探讨A型性格对中老年原发性高血压患者早期肾功能损害的影响及贝那普利对其的保护作用.方法 根据A型性格量表,在中老年原发性高血压患者中筛查出80例A型性格(A型性格组)和80例非A型性格(非A型性格组),给予贝那普利干预治疗,初始计量10 mg/d,剂量递增,使血压达标,在1个月内使最大剂量增至20 mg/d,服药6个月.采集一般临床资料并分别在治疗前、后测定患者血浆的血管紧张素Ⅱ(AngⅡ)、尿微量白蛋白排泄率(UAER)、尿β2-微球蛋白(β2-MG).结果 两组年龄、性别、体质指数(BMI)、尿素(BUN)、肌酐(Cr)、收缩压及舒张压差异无统计学差异(均P>0.05).A型性格组较非A型性格组AngⅡ[(60.3±11.6)mg/L与(55.8±10.2)mg/L]、UAER[(83.3±23.3)μg/min与(75.7±16.3)μg/min]、β2-MG[(75.6±24.5)mmol/L与(66.0±19.4)mmol/L]增高,差异均有统计学意义(t值分别为2.598、2.603、2.742,P值分别为0.016、0.012、0.008);2组的A型性格分值与AngⅡ、UAER、β2-MG呈正相关(r值分别为0.361、0.198和0.202,P值分别为0.002、0.015、0.021),经多元逐步回归分析,AngⅡ为其独立危险因素(β=0.291,t=2.793,P=0.008).用药后2组的收缩压、舒张压、AngⅡ、UAER及β2-MG均显著下降,并且2组中AngⅡ的变化值与UAER(r=0.373,P=0.005;r=0.282,P=0.032)及B2-MG(r=0.385,P=0.003;r=0.279,P=0.039)的变化值亦呈正相关.结论 A型性格可通过应激系统加重中老年原发性高血压患者早期肾功能损害,贝那普利对其具有较好的保护作用.
目的 探討A型性格對中老年原髮性高血壓患者早期腎功能損害的影響及貝那普利對其的保護作用.方法 根據A型性格量錶,在中老年原髮性高血壓患者中篩查齣80例A型性格(A型性格組)和80例非A型性格(非A型性格組),給予貝那普利榦預治療,初始計量10 mg/d,劑量遞增,使血壓達標,在1箇月內使最大劑量增至20 mg/d,服藥6箇月.採集一般臨床資料併分彆在治療前、後測定患者血漿的血管緊張素Ⅱ(AngⅡ)、尿微量白蛋白排洩率(UAER)、尿β2-微毬蛋白(β2-MG).結果 兩組年齡、性彆、體質指數(BMI)、尿素(BUN)、肌酐(Cr)、收縮壓及舒張壓差異無統計學差異(均P>0.05).A型性格組較非A型性格組AngⅡ[(60.3±11.6)mg/L與(55.8±10.2)mg/L]、UAER[(83.3±23.3)μg/min與(75.7±16.3)μg/min]、β2-MG[(75.6±24.5)mmol/L與(66.0±19.4)mmol/L]增高,差異均有統計學意義(t值分彆為2.598、2.603、2.742,P值分彆為0.016、0.012、0.008);2組的A型性格分值與AngⅡ、UAER、β2-MG呈正相關(r值分彆為0.361、0.198和0.202,P值分彆為0.002、0.015、0.021),經多元逐步迴歸分析,AngⅡ為其獨立危險因素(β=0.291,t=2.793,P=0.008).用藥後2組的收縮壓、舒張壓、AngⅡ、UAER及β2-MG均顯著下降,併且2組中AngⅡ的變化值與UAER(r=0.373,P=0.005;r=0.282,P=0.032)及B2-MG(r=0.385,P=0.003;r=0.279,P=0.039)的變化值亦呈正相關.結論 A型性格可通過應激繫統加重中老年原髮性高血壓患者早期腎功能損害,貝那普利對其具有較好的保護作用.
목적 탐토A형성격대중노년원발성고혈압환자조기신공능손해적영향급패나보리대기적보호작용.방법 근거A형성격량표,재중노년원발성고혈압환자중사사출80례A형성격(A형성격조)화80례비A형성격(비A형성격조),급여패나보리간예치료,초시계량10 mg/d,제량체증,사혈압체표,재1개월내사최대제량증지20 mg/d,복약6개월.채집일반림상자료병분별재치료전、후측정환자혈장적혈관긴장소Ⅱ(AngⅡ)、뇨미량백단백배설솔(UAER)、뇨β2-미구단백(β2-MG).결과 량조년령、성별、체질지수(BMI)、뇨소(BUN)、기항(Cr)、수축압급서장압차이무통계학차이(균P>0.05).A형성격조교비A형성격조AngⅡ[(60.3±11.6)mg/L여(55.8±10.2)mg/L]、UAER[(83.3±23.3)μg/min여(75.7±16.3)μg/min]、β2-MG[(75.6±24.5)mmol/L여(66.0±19.4)mmol/L]증고,차이균유통계학의의(t치분별위2.598、2.603、2.742,P치분별위0.016、0.012、0.008);2조적A형성격분치여AngⅡ、UAER、β2-MG정정상관(r치분별위0.361、0.198화0.202,P치분별위0.002、0.015、0.021),경다원축보회귀분석,AngⅡ위기독립위험인소(β=0.291,t=2.793,P=0.008).용약후2조적수축압、서장압、AngⅡ、UAER급β2-MG균현저하강,병차2조중AngⅡ적변화치여UAER(r=0.373,P=0.005;r=0.282,P=0.032)급B2-MG(r=0.385,P=0.003;r=0.279,P=0.039)적변화치역정정상관.결론 A형성격가통과응격계통가중중노년원발성고혈압환자조기신공능손해,패나보리대기구유교호적보호작용.
Objective To explore the influence of type A character on early renal impairment in elderly patients with essential hypertension and the protective effect of benazepril. Methods According to the type A behavior measuring scale, 80 cases with type A character and 80 cases without type A character were screened out from the elderly patients with essential hypertension. The patients received benazepril intervention with incipient dose of 10 mg daily, which increased gradually to the largest does of 20 mg daily within 1 month, The treatment lasted 6 months in order to make the patients achieve the normal blood pressure (BP). The general data, plasma angiotensin Ⅱ (AngⅡ )> urinary albumin excretion rate (UAER) and urinary β2-microglobulin (β2-MG) were measured at pretherapy and post-treatment respectively. Results There were no statistically significant differences at pretherapy between the two groups in age, gender, body mass index (BMI), blood urea nitrogen (BUN), creatinine (Cr), systolic pressure and diastolic pressure (all P>0.05). Ang Ⅱ [(60.3±11.6)mg/Lvs (55.8±10.2)mg/L], UAER[(83.3±23.3)μg/min vs. (75.7±16.3)μg/min] and β2-MG [(75.6±24.5)mmol/L vs. (66.0±19.4)mmol/L] were significantly higher in type A character group than in non-type A character group (t=2.598, 2.603, 2.742; P= 0.016,0.012, 0.008). TypeA character value of the two groups showed a positive correlation with Ang Ⅱ (r= 0.361, P=0.002), UAER (r=0.198, P=0.015) and β2-MG (r=0.202, P = 0.021). Only Ang Ⅱ (β=0.291, t=2.793, P= 0.008) was correlated to type A character value independently by multiple stepwise regression analysis. Before treatment in both of the type A character group and the non-type-A character group, there was a positive correlation between Ang II and UAER, (β2-MG, and obvious correlation in type-A character group. The systolic pressure, diastolic pressure, Ang Ⅱ , UREA and β2-MG were all decreased obviously in two groups post treatment. And the variable value of AngⅡ was also positively correlated with UAER (r=0.373, P=0.005; r=0.282, P=0.032), fr-MG (r= 0.385, P=0.003; r= 0.279, P=0.039) before and after treatment. Conclusions Type A character can aggravate injury of early renal function by certain stress systems in the elderly patients with essential hypertension and benazepril has better protective effect for it.
