CAJ | 학술논문

目的探讨血清脂联素水平与原发性高血压(EH)患者肾脏损害的关系.方法选择我院确诊为EH的门诊及住院患者60例(EH组33,以及体质指数(BMI)、年龄、性别匹配的健康体检者60例(对照组).用酶联免疫吸附(ELISA)法检测其血清脂联素浓度;用放射免疫法(RIA)测定尿微量白蛋白(MA)浓度,计算24 h尿白蛋白排泄量(UAE);进行24 h动态血压监测(ABPM)及常规的临床和实验室指标的检测.EH组以UAE值为基础,分为MA(-)/EH亚组和MA(+)/EH亚组.采用SPSS 11.5统计软件进行统计分析.结果 EH组脂联素浓度不呈正态分布,取其对数值进行统计学分析.EH组1g(脂联素浓度)为(0.96±0.21)mg/L,对照组为(1.06±0.16)mg/L,组间比较差异有统计学意义(t=2.934,P<0.01).EH组UAE<30 mg/24h 20例,30～300 mg/24h 40例,2组1g(脂联素浓度)与UAE呈显著负相关(r=-0.532,P<0.01),校正各因素后仍呈显著负相关(偏相关系数r=-0.279,P=0.036).EH组中动态血压节律杓形34例,非杓形26例,UAE分别为(21.17±11.08)mg/24 h和(28.20±12.48)mg/24 h,差异有统计学意义(t=2.280,P<0.05),2组1g(脂联素浓度)差异无统计学意义.结论 EH患者血清脂联素浓度低于正常对照者,低脂联素血症与EH的发生、发展有一定关系.EH患者中,MA伴有血清脂联素浓度的降低.低脂联素血症与EH患者MA的发生密切相关,脂联素可能有保护EH患者肾脏以及血管内皮功能的作用.血压昼夜节律异常促进了MA的发生.
목적 탐토혈청지련소수평여원발성고혈압(EH)환자신장손해적관계.방법 선택아원학진위EH적문진급주원환자60례(EH조33,이급체질지수(BMI)、년령、성별필배적건강체검자60례(대조조).용매련면역흡부(ELISA)법검측기혈청지련소농도;용방사면역법(RIA)측정뇨미량백단백(MA)농도,계산24 h뇨백단백배설량(UAE);진행24 h동태혈압감측(ABPM)급상규적림상화실험실지표적검측.EH조이UAE치위기출,분위MA(-)/EH아조화MA(+)/EH아조.채용SPSS 11.5통계연건진행통계분석.결과 EH조지련소농도불정정태분포,취기대수치진행통계학분석.EH조1g(지련소농도)위(0.96±0.21)mg/L,대조조위(1.06±0.16)mg/L,조간비교차이유통계학의의(t=2.934,P<0.01).EH조UAE<30 mg/24h 20례,30～300 mg/24h 40례,2조1g(지련소농도)여UAE정현저부상관(r=-0.532,P<0.01),교정각인소후잉정현저부상관(편상관계수r=-0.279,P=0.036).EH조중동태혈압절률표형34례,비표형26례,UAE분별위(21.17±11.08)mg/24 h화(28.20±12.48)mg/24 h,차이유통계학의의(t=2.280,P<0.05),2조1g(지련소농도)차이무통계학의의.결론 EH환자혈청지련소농도저우정상대조자,저지련소혈증여EH적발생、발전유일정관계.EH환자중,MA반유혈청지련소농도적강저.저지련소혈증여EH환자MA적발생밀절상관,지련소가능유보호EH환자신장이급혈관내피공능적작용.혈압주야절률이상촉진료MA적발생.
Objective To investigate the relationship between serum adiponectin and kidney function in pa-tient ofessential hypertension(EH). Methods We conducted a case-eontroul study of 60 EH patient(EH group) and 60 normal subjects of the same body mass index(BMI)、sxe and age (control group). Serum adiponectin levels was assessed by enzyme linked immunosorbent assay (ELISA) and microalbumin was detected by radioimmunoassay (RIA), 24-hour urinary albumin excretion(UAE) was calculated. Ambulatory blood pressure monitoring were re-corded and other routine parameters about clinical and laboratory were assessed. According to UAE, we divided EH group into MA(-)/EH groups who had normal albuminuria(n=40, UAE<30 mg/24 h) and MA(+)/EH group who had microalbuminuria(n=20,30≤UAE<300 mg/24 h). Results The 1g(adiponectin) values in EH group is significantly lower than control group (t=2.934,P<0.01). In EH group, there was a negative correlation be-tween lg(adiponectin) and UAE(r=-0.532,P<0.01). Subjects who had microalbminuria in EH group had ab-normal circadian rhythm of blood pressure. There was a significantly difference between non-dipper EH group and dipper EH group regarding the UAG (t=2.280, P<0.05). Conclusion The hypo-adiponectinemia is one of the risk factors for EH. There is a correlation between hypo-adiponectinemia and the microalbuminuria, therefore adi-ponectin may be a protective factor of renal dysfunction. The abnormality of rhythm of blood pressure can induce mi-croalbuminuria in patient with EH.