CAJ | 학술논문

目的：通过比较慢性盐负荷及补钾试验干预后血浆一氧化氮（NO）水平、24小时尿微量白蛋白排泄量的变化及其相关性，探讨盐敏感者24小时尿微量白蛋白排泄量与血管内皮功能损伤的关系及补钾的保护作用。方法选择50例20～65岁血压正常者或Ⅰ级高血压（140～159/90～99 mmHg）患者参与为期24天的慢性盐负荷及补钾干预试验，包括基线期3天，低盐期、高盐期、高盐补钾期各7天。测量受试者各期血压并收集血、尿标本，测量血浆NO水平及24小时尿微量白蛋白水平。结果50例受试者中共49例完成全部干预试验，盐敏感者检出率为42.9%（21/49）。慢性盐负荷后，盐敏感者血浆NO水平较低盐期显著降低（P＜0.01），而24小时尿微量白蛋白水平则显著升高（P＜0.01）。补钾可逆转高盐期引起的盐敏感者血浆NO水平下降，同时减少24小时尿微量白蛋白排泄量（P＜0.05）。低盐期、高盐期血浆NO水平和24小时尿微量白蛋白水平呈显著负相关。结论高盐干预可降低盐敏感者血浆NO水平，增加其24小时尿微量白蛋白排泄量；补钾可改善血管内皮功能，减少24小时尿微量白蛋白排泄量。
목적：통과비교만성염부하급보갑시험간예후혈장일양화담（NO）수평、24소시뇨미량백단백배설량적변화급기상관성，탐토염민감자24소시뇨미량백단백배설량여혈관내피공능손상적관계급보갑적보호작용。방법선택50례20～65세혈압정상자혹Ⅰ급고혈압（140～159/90～99 mmHg）환자삼여위기24천적만성염부하급보갑간예시험，포괄기선기3천，저염기、고염기、고염보갑기각7천。측량수시자각기혈압병수집혈、뇨표본，측량혈장NO수평급24소시뇨미량백단백수평。결과50례수시자중공49례완성전부간예시험，염민감자검출솔위42.9%（21/49）。만성염부하후，염민감자혈장NO수평교저염기현저강저（P＜0.01），이24소시뇨미량백단백수평칙현저승고（P＜0.01）。보갑가역전고염기인기적염민감자혈장NO수평하강，동시감소24소시뇨미량백단백배설량（P＜0.05）。저염기、고염기혈장NO수평화24소시뇨미량백단백수평정현저부상관。결론고염간예가강저염민감자혈장NO수평，증가기24소시뇨미량백단백배설량；보갑가개선혈관내피공능，감소24소시뇨미량백단백배설량。
Objective By ovserving the levels of plasma nitric oxide (NO) and 24 hours urinary microalbumin after salt loading and potassium supplement, to investigate the relationship of endothelial function injury and urine protein excretion in the salt-sensitive (SS) persons and the protective effect of potassium. Method 50 normotensive and levelⅠhypertensive (140~159/90~99 mmHg) subjects aged from 20 ~ 65 years were sequentially maintained on a protocol with 3 days baseline, 7 days low salt diet, 7 days high salt diet, and high salt diet with potassium supplementation for another 7 days. The physical index, venous blood and 24 hours urine were collected at the end of each period, the NO metabolite (NOx) and the 24 hours urinary microalbumin were measured. Result There were 49 out of 50 subjects completed the whole intervention experiment. The SS detection rate was 42.9% (21/49). After salt loading, the NO levels were apparently reduced (P<0.01) in the SS group, and 24 hours urinary microalbumin was signiifcantly increased (P<0.01). Potassium can reverse the plasma NO levels and 24 hours urinary microalbumin in the SS group (P<0.05);the correlation analysis between plasma NO levels and 24 hours urinary microalbumin during the intervention showed that the plasma NO level and 24 hours urinary microalbumin levels presented a remarkably negative correlation during LS phase and HS phase. Conclusion High salt intervention can significantly increase urinary protein excretion in the salt-sensitive subjects and this may be related to endothelial dysfunction, potassium can improve endothelial function and reduce 24 hours urinary protein excretion.