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目的:观察正常血压高值患者肾功能的变化,以探讨正常血压高值患者是否存在与血压升高相关的靶器官损害,以指导其治疗和预防。方法:根据JNC-7诊断标准筛选病例并分为3组:正常血压组(NT组)56例;正常血压高值组(PH组)51例;高血压组(EH组)54例。留取晨尿,抽取静脉血,离心后采用放免法和酶法测定尿β2-微球蛋白(β2-MG)、尿微量白蛋白(mAIb)及血尿素氮(BUN)、血肌酐(Cr)。结果:与NT组相比,PH组和EH组尿β2-MG、mAIb水平明显升高(P<0.05;P<0.01);BUN、Cr在EH组明显升高,与NT组比较P<0.01;在PH组BUN轻度升高,与NT组比较无显著性差异;血Cr明显升高,与NT组比较P<0.01。直线相关分析显示:血压水平与尿β2-MG、mAIb及BUN、Cr的水平均呈显著正相关。多因素回归分析显示:校正年龄、体质指数、血糖、胆固醇、TG,血压水平仍与尿β2-MG、mAIb有显著的相关性。结论:PH组患者尿β2-MG、mAIb、Cr出现了异常变化。且血压水平与尿β2-MG、mAIb及BUN、Cr的水平均呈显著正相关。提示正常血压高值患者可能存在与血压升高相关的肾损害。血压水平是导致尿β2-MG、尿mAIb增加的独立危险因素。
OBJECTIVE: To observe the changes of renal function in patients with high normoal hypertension to explore whether there exists target organ damage associated with elevated blood pressure in patients with high normotensive, so as to guide its treatment and prevention. Methods: According to JNC-7 diagnostic criteria, the patients were screened and divided into three groups: 56 in normal blood pressure group (NT group), 51 in normal blood pressure group (PH group) and 54 in hypertensive group (EH group). Blood samples were collected for morning urine and venous blood was collected. After centrifugation, β2-microglobulin (β2-MG), mAb, urinary albumin (BUN) and serum creatinine (Cr) . Results: Compared with NT group, the levels of urinary β2-MG and mAIb in PH group and EH group were significantly increased (P <0.05; P <0.01); BUN and Cr were significantly increased in EH group compared with NT group, P <0.01 ; BUN slightly increased in PH group, compared with NT group no significant difference; blood Cr significantly increased, compared with NT group P <0.01. Linear correlation analysis showed that there was a significant positive correlation between blood pressure and urinary β2-MG, mAIb, BUN and Cr levels. Multivariate regression analysis showed that: age at correction, body mass index, blood glucose, cholesterol, TG, blood pressure levels were still significantly associated with urine β2-MG, mAIb. Conclusion: The abnormal changes of urinary β2-MG, mAIb and Cr in PH group patients. And the level of blood pressure and urinary β2-MG, mAIb and BUN, Cr levels were significantly positive correlation. This suggests that patients with high normotension may have renal damage associated with elevated blood pressure. Blood pressure level is an independent risk factor for urinary β2-MG and urinary mAIb.