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目的探索高血压人群中尿钠、尿钾和尿钠钾比值水平与血压和动脉僵硬度的关系。方法入选未服用降压药的高血压患者224例,按照标准留取24h尿标本,检测尿钾、尿钠含量和尿钠钾比值。根据24h尿钠水平分为3组,尿钠≤100mmol/24h(A组)、>100～200(B组)和>200mmol/24h组(C组)。对上述患者进行24h动态血压监测和臂踝动脉脉搏波传导速度(baPWV)检查。结果人群平均24h尿钠值为(160.0±69.4)mmol/24h,所对应食盐摄入量为9.6g/d,平均尿钠钾比值为4.8。A、B、C3组人群的平均尿钠值分别为(84.9±12.7)、(147.0±26.7)和(256.1±42.6)mmol/24h,所对应平均摄盐量为5.1、8.8和15.3g/d。C组24h、白昼、夜间收缩压、舒张压明显高于A组(P<0.01)。全人群多元线性回归分析显示,尿钠和钠钾比值与24h收缩压、舒张压以及脉压呈正相关(β值分别为0.221、0.188,0146、0.211,0.136、0.142,均P<0.05)。A、B、C3组人群的baPWV分别为(1621.6±288.3)、(1645.7±301.0)和(1741.9±307.0)cm/s,C组明显高于A组和B组(P=0.032,P=0.046),多元线性回归分析显示,尿钠和钠钾比值是baPWV的独立影响因素(β值分别为0.126,0.158,均P<0.05)。结论尿钠和钠钾比值不仅与血压水平密切相关,而且与baPWV密切相关,这种关系是独立于血压作用之外的。
Objective To explore the relationship between urinary sodium, urinary potassium, urinary sodium, potassium and blood pressure and arterial stiffness in hypertensive population. Methods Totally 224 hypertensive patients who did not take antihypertensive drugs were enrolled in this study. 24 h urinary samples were collected according to the standard and urinary potassium, urinary sodium and urinary sodium and potassium ratio were measured. The patients were divided into 3 groups according to the level of urinary sodium for 24 hours. Urinary sodium ≤100mmol / 24h (group A),> 100 ~ 200 (group B) and> 200mmol / 24h group (group C). The patients were monitored for ambulatory blood pressure at 24 hours and brachial-ankle pulse wave velocity (baPWV). Results The average urinary sodium value of the population was (160.0 ± 69.4) mmol / 24h, the corresponding salt intake was 9.6g / d, and the average urine sodium-potassium ratio was 4.8. The average urinary sodium values in groups A, B and C3 were (84.9 ± 12.7), (147.0 ± 26.7) and (256.1 ± 42.6) mmol / 24h, respectively, with corresponding mean salt values of 5.1, 8.8 and 15.3 g / d . C group 24h, daytime, night systolic pressure, diastolic pressure was significantly higher than the A group (P <0.01). Multivariate linear regression analysis of the whole population showed that the ratio of urinary sodium and sodium to potassium was positively correlated with systolic blood pressure, diastolic blood pressure and pulse pressure (β = 0.221,0.188,0146,0.211,0.136,0.142, P <0.05 respectively). The baPWV values in groups A, B and C3 were (1621.6 ± 288.3) and (1645.7 ± 301.0) and (1741.9 ± 307.0) cm / s, respectively, and those in group C were significantly higher than those in groups A and B (P = 0.032, ), Multivariate linear regression analysis showed that natriuretic and sodium-potassium ratio is an independent factor of baPWV (β values were 0.126,0.158, P <0.05, respectively). Conclusion The ratio of urinary sodium and sodium to potassium is not only closely related to blood pressure but also closely related to baPWV, which is independent of blood pressure.