中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2015年
4期
308-311
,共4页
朱航%薛浩%王广义%付振虹%刘杰%石亚军
硃航%薛浩%王廣義%付振虹%劉傑%石亞軍
주항%설호%왕엄의%부진홍%류걸%석아군
高血压%蛋白尿
高血壓%蛋白尿
고혈압%단백뇨
Hypertension%Proteinuria
目的 探讨高血压患者尿微量白蛋白肌酐比值(urinary albuminto-ereatinine ratio,ACR),与肱踝动脉脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的关系.方法 入选2009年9月至2012年12月门诊原发性高血压患者877例,根据测定的随机ACR分为3组,即ACR正常组(ACR＜ 30 mg/g,n =723)、微量白蛋白尿组(30 mg/g≤ACR＜ 300 mg/g,n=136)和大量白蛋白尿组(ACR≥300 mg/g,n=18).采用全自动动脉硬化测定仪,测定所有患者双侧baPWV,取双侧baPWV平均值,分析高血压患者ACR与baPWV之间的相关性.结果 微量白蛋白尿组和大量白蛋白尿组高血压患者baPWV水平均明显高于ACR正常组(P均＜0.05),且大量白蛋白尿组高血压患者baPWV水平明显高于微量白蛋白尿组(P＜0.05).线性相关分析结果显示高血压患者ACR与baPWV呈正相关(r=0.413,P＜0.01).进一步应用多元线性回归分析调整了年龄、性别、体质指数、收缩压、舒张压、血糖、血清胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯等心血管危险因素的影响后,ACR与baPWV仍相关(标化的相关系数β=0.29,R2 =0.112,P＜0.01).进一步以ACR＜ 30 mg/g和ACR≥30 mg/g为二分变量,应用二分类logistic回归调整了心血管危险因素后,结果显示ACR≥30 mg/g是baPWV升高的独立危险因素(OR:1.73,95％ CI:1.62～2.98).结论 高血压患者baPWV增加与ACR水平升高显著相关,可能是高血压早期肾功能损害的独立危险因素.
目的 探討高血壓患者尿微量白蛋白肌酐比值(urinary albuminto-ereatinine ratio,ACR),與肱踝動脈脈搏波傳導速度(brachial-ankle pulse wave velocity,baPWV)的關繫.方法 入選2009年9月至2012年12月門診原髮性高血壓患者877例,根據測定的隨機ACR分為3組,即ACR正常組(ACR＜ 30 mg/g,n =723)、微量白蛋白尿組(30 mg/g≤ACR＜ 300 mg/g,n=136)和大量白蛋白尿組(ACR≥300 mg/g,n=18).採用全自動動脈硬化測定儀,測定所有患者雙側baPWV,取雙側baPWV平均值,分析高血壓患者ACR與baPWV之間的相關性.結果 微量白蛋白尿組和大量白蛋白尿組高血壓患者baPWV水平均明顯高于ACR正常組(P均＜0.05),且大量白蛋白尿組高血壓患者baPWV水平明顯高于微量白蛋白尿組(P＜0.05).線性相關分析結果顯示高血壓患者ACR與baPWV呈正相關(r=0.413,P＜0.01).進一步應用多元線性迴歸分析調整瞭年齡、性彆、體質指數、收縮壓、舒張壓、血糖、血清膽固醇、低密度脂蛋白膽固醇、高密度脂蛋白膽固醇、甘油三酯等心血管危險因素的影響後,ACR與baPWV仍相關(標化的相關繫數β=0.29,R2 =0.112,P＜0.01).進一步以ACR＜ 30 mg/g和ACR≥30 mg/g為二分變量,應用二分類logistic迴歸調整瞭心血管危險因素後,結果顯示ACR≥30 mg/g是baPWV升高的獨立危險因素(OR:1.73,95％ CI:1.62～2.98).結論 高血壓患者baPWV增加與ACR水平升高顯著相關,可能是高血壓早期腎功能損害的獨立危險因素.
목적 탐토고혈압환자뇨미량백단백기항비치(urinary albuminto-ereatinine ratio,ACR),여굉과동맥맥박파전도속도(brachial-ankle pulse wave velocity,baPWV)적관계.방법 입선2009년9월지2012년12월문진원발성고혈압환자877례,근거측정적수궤ACR분위3조,즉ACR정상조(ACR＜ 30 mg/g,n =723)、미량백단백뇨조(30 mg/g≤ACR＜ 300 mg/g,n=136)화대량백단백뇨조(ACR≥300 mg/g,n=18).채용전자동동맥경화측정의,측정소유환자쌍측baPWV,취쌍측baPWV평균치,분석고혈압환자ACR여baPWV지간적상관성.결과 미량백단백뇨조화대량백단백뇨조고혈압환자baPWV수평균명현고우ACR정상조(P균＜0.05),차대량백단백뇨조고혈압환자baPWV수평명현고우미량백단백뇨조(P＜0.05).선성상관분석결과현시고혈압환자ACR여baPWV정정상관(r=0.413,P＜0.01).진일보응용다원선성회귀분석조정료년령、성별、체질지수、수축압、서장압、혈당、혈청담고순、저밀도지단백담고순、고밀도지단백담고순、감유삼지등심혈관위험인소적영향후,ACR여baPWV잉상관(표화적상관계수β=0.29,R2 =0.112,P＜0.01).진일보이ACR＜ 30 mg/g화ACR≥30 mg/g위이분변량,응용이분류logistic회귀조정료심혈관위험인소후,결과현시ACR≥30 mg/g시baPWV승고적독립위험인소(OR:1.73,95％ CI:1.62～2.98).결론 고혈압환자baPWV증가여ACR수평승고현저상관,가능시고혈압조기신공능손해적독립위험인소.
Objective To explore the association between urinary microalbumin-to-creatinine ratio (ACR) and brachial-ankle pulse wave velocity (baPWV) in hypertensive patients.Methods A total of 877 primary hypertension patients were enrolled in this trial from September 2009 to December 2012,and were randomly recruited and patients were divided into normal ACR group (ACR ＜ 30 mg/g,n =723),microalbuminuria group (30 mg/g ≤ ACR ＜ 300 mg/g,n =136) and macro-albuminuria group (ACR ≥300 mg/g,n =18).baPWV was measure by automatic pulse wave velocity measuring system.Results The baPWV values in patients of micro-albuminuria group and macro-albuminuria group were significantly higher than in the normal ACR group (all P ＜ 0.05).The baPWV value of macro-albuminuria group was significantly higher than in the micro-albuminuria group (P ＜ 0.05).Linear correlation analysis revealed that ACR was positively correlated with baPWV (r =0.413,P ＜ 0.01).Multiple linear regression analysis showed that ACR independently correlated with baPWV in patients with primary hypertension (β =0.29,R2 =0.112,P ＜ 0.01) after adjusting for age,sex,body mass index,systolic blood pressure,diastolic blood pressure,blood glucose,total cholesterol,low density lipoprotein,high density lipoprotein and triglyceride.Using ACR ＜ 30 mg/g and ACR ≥ 30 mg/g as dichotomous variable,binary logistic regression analysis showed that ACR≥30 mg/g was also a risk factor of the ascending baPWV in primary hypertension patients (OR:1.73,95％ CI:1.62-2.98) after adjusting the traditional cardiovascular risk factors.Conclusion ACR is positively correlated to baPWV in primary hypertension patients,and the ascending baPWV is a risk factor of early renal dysfunction in primary hypertension patients.
