24小时动态血压昼夜节律与微量白蛋白尿相关性研究-中国循环杂志.PDFVIP

176 中国循环杂志 2014 年 3 月 第 29 卷 第 3 期（总第 189 期）Chinese Circulation Journal，March，2014，Vol. 29 No.3（Serial No.189） 高血压研究 24 小时动态血压昼夜节律与微量白蛋白尿相关性研究 孙丽霞，王佳瑞，钟扬，姜一农 摘要 目的：探讨血压昼夜节律与微量白蛋白尿相关性研究。 方法：将 143 例原发性高血压患者分为杓型组及非杓型组，通过 24 小时动态血压监测及测定尿微量白蛋白 / 肌 酐（UACR)、左心室质量指数（LVMI）、脉搏波传导速度（PWV），分析动态血压参数与 UACR 的相关性。 结果：24 小时平均收缩压、24 小时平均舒张压、夜间平均收缩压、夜间平均舒张压、夜间平均脉压与 UACR 之 间均有相关性（相关系数分别为 0.260，0.199，0.442，0.308，0.251），其中夜间平均收缩压与 UACR 的相关性最大（相 关系数为 0.442）。而诊室血压与 UACR 无明显相关。夜间平均收缩压及 LVMI 均与 UACR 独立相关。杓型组及非杓型 组两组患者在 UACR、LVMI 两方面比较差异均有统计学意义（P 0.05), 而在对 PWV 的评价上无差异。 结论：夜间平均收缩压与 UACR 明显相关，异常血压昼夜节律可加重靶器官损害。 关键词 动态血压；尿微量白蛋白 / 肌酐；左心室质量指数；脉搏波传导速度 Relationship Between 24-hour Ambulatory Blood Pressure Circadian Rhythm and Microalbuminuria in Patients With Essential Hypertension SUN Li-xia, WANG Jia-rui, ZHONG Yang, JIANG Yi-nong. Department of Cardiology, The 5th People’s Hospital of Dalian City, Dalian (116011), Liaoning, China Corresponding Author: JIANG Yi-nong, Email: jiangyn64510@ Abstract Objective: To explore the relationship between 24-hour ambulatory blood pressure (ABP) circadian rhythm and microalbuminuria in patients with essential hypertension (EH). Methods: A total of 143 EH patients were divided into 2 groups, Dipper group, n =53 and Non-dipper group, n =90. The relationship between ABP index and urinary micro albumin creatinine ratio (UACR) was analyzed by examining the 24-hour ABP, UACR, left ventricular mass index (LVMI) and pulse wave velocity (PWV) in all patients. Results: The mean 24h-SBP, 24h-DBP, n-SBP, n-DBP, n-PP were related to UACR with the correlation of 0.260, 0.199, 0.442, 0.308, 0.251respectively, and the mean n-SBP had the most closed correlation of 0.442. The office measured blood pressure was not obviously related to UACR. The mean n-S