老年单纯收缩期高血压患者脉搏波传导速度与微量白蛋白尿的相关性研究

摘要

Objective To investigate the effects of change of pulse wave velocity(PWV) on microalbuminuria(MAU) and analyze the correlation of PWV with MAU in patients with isolated systolic hypertension.Methods Carotid-radial PWV (C-RPWV) and carotid-femoral PWV (C-FPWV) were determined in 265 patients with isolated systolic hypertension.The participants were assigned to groups with MAU and without MAU, and their C-FPWV, C-RPWV and incidence of cardiovascular events were compared.Results 149 patients with MAU had significantly higher C-FPWV,C-RPWV and incidence of cardiovascular events than those without MAU.After adjusting the age,systolic blood pressure, diastolic blood pressure and pulse pressure, the OR of MAU was increased with increase in C-FPWV and C-RPWV.Linear correlation analysis showed that C-FPWV and C-RPWV were positively correlated with 24-hour urinary albumin excretion,multiple logistic regression analysis showed that C-FPWV and C-RPWV were independently correlated with MAU.Conclusion MAU was independently correlated with C-FPWV and C-RPWV,C-FPWV and C-RPWV were the risk factors for MAU.%目的 研究老年单纯收缩期高血压患者脉搏波传导速度(PWV)的变化对微量白蛋白尿(MAU)的影响,探讨PWV与MAU的相关性.方法 选择老年单纯收缩期高血压患者265例,采用动脉硬化PWV检测仪检测颈-股动脉PWV(C-FPWV)及颈一桡动脉PWV(C-RPWV),采用免疫比浊法检测患者24 h MAU含量.根据MAU检测结果,分为MAU阴性组(阴性组)116例和MAU阳性组(阳性组)149例,比较2组患者C-FPWV、C-RPWV及各种心血管事件发生率之间的差异,分析PWV与MAU的相关性.结果 与阴性组比较,阳性组患者C-FPWV及C-RPWV明显增高(P＜0.01);总体靶器官损害、左心室肥厚、心肌梗死、外周血管疾病以及肾功能不全发生率明显升高(P＜0.05,P＜0.01);在控制年龄、收缩压、舒张压、脉压以及心率的情况下,MAU阳性的危险性及人数明显增加;C-FPWV、C-RPWV与24 h尿白蛋白排泄量呈显著正相关(r=0.875,P=0.001;r=0.763,P=0.017).logistic回归分析显示,在校正年龄、收缩压、脉压的基础上,C-FPWV、C-RPWV与24 h尿白蛋白排泄量独立相关(P=0.015,P=0.023).结论 PWV增高可明显增加MAU的危险性,C-FPWV、C-RPWV是MAU的独立危险因素.