原发性高血压患者血压晨峰现象与肾功能损害的相关性研究

Research of the relevance between morning blood pressure surge (MBPS) and renal injury in patients with essential hypertension

关键词:  原发性高血压  晨峰血压  肾脏损害  尿微量白蛋白

Key words:  [Key words] 　essential hypertension  morning blood pressure surge  renal injury  urine microalbumin

摘要:

目的　观察原发性高血压病患者晨峰血压对肾功能损伤的影响。方法　应用24 h动态血压监测对206例轻中度原发性高血压病患者按晨峰血压分为年龄、性别无明显差异的晨峰组和非晨峰组。依据24 h尿微量白蛋白及肾功能生化测定，观察并比较患者晨峰血压对肾功能损伤的影响。结果　晨峰组与非晨峰组患者24 h、日间、夜间SBP和DBP的血压平均值差异无显著性意义（P>0.05）；晨峰血压两组差异有显著性意义（P<0.01）,晨峰收缩压分别为（39.60±10.48）mmHg和（15.94±10.07）mmHg，晨峰舒张压分别为（14.76±3.42）mmHg和（10.37±8.83）mmHg； 24 h尿微量白蛋白两组差异有显著性意义（P<0.01），晨峰组与非晨峰组分别为（105.95±26.06）mg/24h和（90.98±23.63）mg/24h； 收缩压的晨峰血压与尿蛋白分泌呈明显正相关（r=0.26,P<0.01），舒张压的晨峰血压与尿蛋白分泌无明显相关性（P>0.05）；血肌酐、血尿素氮两组差异无显著性意义（P>0.05）。结论　原发性高血压病患者收缩压晨峰血压与高血压性肾脏损伤密切相关。

Abstract:

[Abstract] Objective　To observe the influence of the morning blood pressure surge (MBPS) on renal injury in patients with essential hypertension. Methods　The 206 patients with mild-to-moderate essential hypertension were divided into two groups, MBPS and non-MBPS, based on 24 h ambulatory blood pressure monitoring. There were no significant differences in age and gender between the groups. According to 24 hour urine microalbumin and renal function biochemical markers, the effects of MBPS on kidney function were investigated. Results　There were no significant differences in the 24 h, day and night mean SBP and DBP between the MBPS and non-MBPS groups（P>0.05）. However, the two groups showed significant differences (P<0.01) in morning peak systolic blood pressure (39.60±10.48) mmHg in MBPS group and (15.94±10.07) mmHg non-MBPS group, respectively,) and morning peak diastolic blood pressure (14.76±3.42) mmHg in MBPS groups and (10.37±8.83) mmHg in non-MBPS group, respectively). The 24 hour urine microalbumin was also significantly different between the two groups（P<0.01），(105.95±26.06) mg/24h in MBPS group and (90.98±23.63) mg/24h in non-MBPS group, respectively. Morning peak systolic blood pressure was positively correlated to the urine protein secretion (P<0.01). However, there was no correlation between morning peak diastolic blood pressure and urine protein secretion （P>0.05）. Serum creatinine and blood urea nitrogen were no significant different between the two groups（P>0.05）. Conclusion　Morning peak systolic blood pressure is closely related to the renal injury which is caused by high blood pressure in patients with essential hypertension.