目的:观察西宁地区原发性高血压患者尿蛋白代谢指标高血压分级病程和颈动脉粥样硬化的关系.
方法:154例住院病人分为1级组(52例),原发性高血压2级组(48例)、高血压3级组(50例),病程1-20年不等,比较3组患者尿蛋白检测的变化及颈动脉超声检测结果.
结果:尿微量白蛋白(MAU)阳性患者颈总动脉内膜中膜厚度[CCA-IMT:(0.9±0.2 vs 0.8±0.2)mm,P＜0.01]、CCA-内径[(6.9±1.0 vs 6.6+0.9)mm,P＜0.01]、粥样斑块出现率(48.5％ vs36.5％,P＜0.05)均显著高于MAU阴性患者,尿蛋白排泄≥60mg/24h时粥样斑块出现率显著升高(P＜0.05).亚组分析进一步证实,EH组MAU阳性患者颈动脉斑块出现率明显升高(P＜0.05),MS组MAU阳性患者CCA-1MT、CCA-内径明显高于MAU阴性患者(P＜0.05,P＜0.05).
结论:MA阳性患者易出现颈动脉粥样硬化，当尿蛋白排泄60mg/≥24h时这种危险性进一步增加.与MA阴性者比较，MS患者MA阳性者颈动脉损害程度明显加重;高血压患者早期肾功能损害尿蛋邮日性结果与高血压病程及治疗无规律有关，似与高血压分级无明显相关，另外与尿其他检测指标如尿转铁蛋白及尿免疫球蛋白无关，该二项指标并不能反映高血压的早期肾功能损害。
作者：
Zi-feng YangXiao-yan GongChris K.P.MokWen-da GuanTing-ting-ChenShi-guan WuSi-hua PanBen CowlingDe-hui ChenHKU-Pasteur Research Pole
School of Public HealthHKU Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong Special Administrative RegionChina Division of Epidemiology and BiostatisticsSchool of Public HealthThe University of Hong KongHong Kong Special Administrative RegionChina State Key Laboratory of Respiratory Disease
National Clinical Research Center for Respiratory DiseaseFirst Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina Pediatric DepartmentFirst Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina State Key Laboratory of New emerging infectious Disease (Hongkong UniversityChina) Centre of Influenza ResearchSchool of Public HealthHKU Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong Special Administrative RegionChina
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