血浆 Apelin 和血管紧张素Ⅱ水平与高血压早期肾损伤的关系研究

摘要

Objective To investigate the correlations between plasma level of Apelin,of Ang Ⅱ and early renal damage in patients with hypertension. Methods From June 2011 to June 2015 in the First people′s Hospital of Guangzhou,a total of 340 patients with essential hypertension were selected as case group,a total of 340 healthy volunteers admitted to this hospital for physical examination were selected as control group. According to urine micro - albumin and urine creatinine ratio (UACR),patients of case group were divided into A group(UACR≥30 mg/ g,n = 103)and B group(UACR < 30 mg/ g,n= 237). Clinical data was compared between control group and case group,plasma levels of Apelin and AngⅡ were compared between A group and B group,and correlations between plasma level of Apelin,of AngⅡ and mean arterial pressure,UACR were analyzed. Results Systolic blood pressure,diastolic blood pressure,mean arterial pressure,serum creatinine,uric acid,hs - CRp,TG,TC,plasma AngⅡ level and UACR of case group were statistically significantly higher than those of control group,while plasma Apelin level of case group was statistically significantly lower than that of control group(P < 0. 05). plasma Apelin level of A group was statistically significantly lower than that of B group,while plasma AngⅡ level of A group was statistically significantly higher than that of B group(P < 0. 05). pearson correlation analysis showed that,plasma Apelin level was negatively correlated with mean arterial pressure( r = - 0. 154,P = 0. 009 ),UACR( r = - 0. 126,P = 0. 003 ), respectively,while plasma AngⅡ level was positively correlated with mean arterial pressure(r = 0. 218,P = 0. 005),UACR (r = 0. 384,P = 0. 002),respectively. Conclusion plasma Apelin level of hypertension patients is significantly reduced, while the plasma AngⅡ level is significantly elevated,plasma levels of Apelin and AngⅡ are closely correlated with early renal damage in patients with hypertension.%目的：探讨血浆 Apelin 和血管紧张素Ⅱ（AngⅡ）与高血压早期肾损伤的关系。方法选取广州市第一人民医院2011年6月—2015年6月收治的原发性高血压患者340例作为高血压组，另选取同期体检健康志愿者340例作为对照组。根据尿微量清蛋白/尿肌酐比值（UACR）将高血压患者分为早期肾损伤（UACR≥30 mg/ g）组103例和非早期肾损伤（UACR <30 mg/ g）组237例。比较两组受试者临床资料及早期有无肾损伤的高血压患者血浆 Apelin、AngⅡ水平，并分析血浆 Apelin、AngⅡ水平与平均动脉压和 UACR 的相关性。结果高血压组患者收缩压、舒张压、平均动脉压、血肌酐、尿酸、超敏 C 反应蛋白、三酰甘油、总胆固醇、血浆 AngⅡ水平及 UACR 均高于对照组，血浆Apelin 水平低于对照组（P <0.05）。早期肾损伤组患者血浆 Apelin 水平低于非早期肾损伤组，血浆 AngⅡ水平高于非早期肾损伤组（P <0.05）。pearson 相关性分析结果显示，血浆 Apelin 水平与平均动脉压（r =-0.154，P =0.009）、UACR（r =-0.126，P =0.003）呈负相关，血浆 AngⅡ水平与平均动脉压（ r =0.218，P =0.005）、UACR（ r =0.384，P =0.002）呈正相关。结论高血压患者血浆 Apelin 水平降低、AngⅡ水平升高，且与早期肾损伤密切相关。