论文部分内容阅读
背景目前国内外研究发现微量白蛋白尿(MAU)与动态动脉硬化指数(AASI)在一定程度上可预测心血管事件及死亡,但MAU与AASI的相关性尚不明确。目的探讨MAU与血压昼夜节律、AASI等动态血压指标之间的关系。方法筛选无糖尿病和其他致MAU阳性因素的高血压患者400例,其中MAU阳性患者(MAU组)98例,随机抽取302例MAU阴性患者中30例为对照组(NMAU组),分别测定其体质量指数(BMI)、空腹血糖、血脂、肾功能,并行24 h动态血压监测(ABPM)及MAU测定,计算AASI和昼夜节律,进一步在MAU组间进行相关性分析。结果MAU阳性率为24.5%(98/400)。MAU组患者高血压病程、总肌酐、夜间脉压、AASI水平显著高于NMAU组(P<0.05)。MAU组中77例患者的动态血压昼夜节律呈非杓型改变,占78.6%,明显高于NMAU组的60.0%(P<0.05)。多元线性逐步回归结果显示MAU与AASI具有明显的相关性(β=0.75,P<0.01)。结论高血压患者MAU阳性与动态血压脉压增加、昼夜节律改变、AASI值增大相关联。
Background Domestic and foreign studies have found that microalbuminuria (MAU) and dynamic arteriosclerosis index (AASI) can predict cardiovascular events and death to some extent, but the correlation between MAU and AASI is not yet clear. Objective To explore the relationship between MAU and ambulatory blood pressure and circadian rhythm, AASI and other ambulatory blood pressure indicators. Methods 400 cases of hypertensive patients without diabetes mellitus and other MAU-positive factors were screened, including 98 cases of MAU positive patients (MAU group), 30 cases of 302 MAU negative patients were randomly selected as the control group (NMAU group) The AASI and circadian rhythm were calculated according to the BMI, fasting blood glucose, blood lipid, renal function, 24-hour ambulatory blood pressure monitoring (ABPM) and MAU. Results The positive rate of MAU was 24.5% (98/400). The course of hypertension, total creatinine, pulse pressure at night and AASI in MAU group were significantly higher than those in NMAU group (P <0.05). In the MAU group, the circadian rhythm of ambulatory blood pressure was non-dipper in 77 patients (78.6%), which was significantly higher than that in NMAU group (60.0%, P <0.05). Multiple linear stepwise regression showed significant correlation between MAU and AASI (β = 0.75, P <0.01). Conclusions The positive MAU in patients with hypertension is associated with the increase of ambulatory blood pressure and pulse pressure, the change of circadian rhythm and the increase of AASI.