CAJ | 학술논문

目的：研究老年杓型高血压患者的晨峰血压（MBPS）现象与尿微量白蛋白/肌酐（UmAlb/Cr）的关系，明确其对肾脏功能的潜在损害。 　　方法：收集225例老年杓型高血压患者，根据动态血压监测（ABPM）结果分为观察组（有晨峰血压的102例）及对照组（无晨峰血压的123例），均行UmAlb/Cr、血尿素氮（BUN）、肌酐（Cr）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、胆固醇（TC）检测，分析两组间UmAlb/Cr的差异。 　　结果：两组患者之间的性别例数比、病程、年龄、血BUN、Cr、HDL-C、LDL-C、TG、TC差异无统计学意义（P>0.05）。观察组较对照组的血压晨峰变异幅度显著升高[（△晨峰血压mmHg（：33.82±8.26）比（14.01±6.15），P=0.01）]。不同性别观察组UmAlb/Cr均高于对照组[mg/mmol：男性（4.92±1.91）比（2.48±1.95），P=0.001，女性（5.49±2.04）比（3.95±2.37），P=0.03]。 　　结论：具有MBPS现象的老年杓型高血压患者较无MBPS现象者更易出现早期肾功能损害。
목적：연구노년표형고혈압환자적신봉혈압（MBPS）현상여뇨미량백단백/기항（UmAlb/Cr）적관계，명학기대신장공능적잠재손해。 　　방법：수집225례노년표형고혈압환자，근거동태혈압감측（ABPM）결과분위관찰조（유신봉혈압적102례）급대조조（무신봉혈압적123례），균행UmAlb/Cr、혈뇨소담（BUN）、기항（Cr）、고밀도지단백담고순（HDL-C）、저밀도지단백담고순（LDL-C）、감유삼지（TG）、담고순（TC）검측，분석량조간UmAlb/Cr적차이。 　　결과：량조환자지간적성별례수비、병정、년령、혈BUN、Cr、HDL-C、LDL-C、TG、TC차이무통계학의의（P>0.05）。관찰조교대조조적혈압신봉변이폭도현저승고[（△신봉혈압mmHg（：33.82±8.26）비（14.01±6.15），P=0.01）]。불동성별관찰조UmAlb/Cr균고우대조조[mg/mmol：남성（4.92±1.91）비（2.48±1.95），P=0.001，녀성（5.49±2.04）비（3.95±2.37），P=0.03]。 　　결론：구유MBPS현상적노년표형고혈압환자교무MBPS현상자경역출현조기신공능손해。
Objective: To study the morning blood pressure surge (MBPS) phenomenon in elder patients with dipper essential hypertension, and to explore the relationship between MBPS and the ratio of urinary albumin/creatinine (UmAlb/Cr) in order to clarify the potential damage of renal function caused by MBPS. Methods: A total of 225 elder patients with dipper hypertension were studied. According to ambulatory blood pressure monitoring (ABPM), the patients were divided into 2 groups:MBPS group, n=102 and Non-MBPS group, n=123. The ratio of UmAlb/Cr, the blood levels of urea nitrogen (BUN), creatinine (Cr), glucose (Glu), high density lipoprotein cholesterol (HDL-C), LDL-C, triglyceride (TG) and total cholesterol (TC) were examined and compared between 2 groups. Results: The gender ratio, course of hypertension, age, blood levels of BUN, Cr, HDL-C, LDL-C, TG and TC were similar between 2 groups, all P>0.05. The MBPS group showed signiifcantly increased variation of MBPS than that in Non-MBPS group, as △MBPS:(33.82 ± 8.26) mmHg vs (14.01 ± 6.15) mmHg, P=0.01. The MBPS group had the higher ratio of UmAlb/Cr than those in Non-MBPS group, as in male:(4.92 ±1.91) mg/mmol vs (2.48 ± 1.95) mg/mmol, P=0.001, and in female:(5.49 ± 2.04) mg/mmol vs (3.95 ± 2.37)mg/mmol, P=0.03. Conclusion: The elder patients with dipper hypertension and MBPS are more prone to suffer from the early renal damage than those non-MBPS patients.