| 冯晓娟,杨香花,张晓玲,刘丽丽,温树彬.原发性高血压患者动态动脉硬化指数与颈动脉粥样硬化及早期肾损害的相关性研究[J].,2019,19(7):1328-1331 |
| 原发性高血压患者动态动脉硬化指数与颈动脉粥样硬化及早期肾损害的相关性研究 |
| Correlation between Ambulatory Arterial Stiffness Index and Carotid Atherosclerosis and Early Renal Damage in Patients with Essential Hypertension |
| 投稿时间：2018-09-12 修订日期：2018-09-30 |
| DOI：10.13241/j.cnki.pmb.2019.07.029 |
| 中文关键词: 原发性高血压 动态动脉硬化指数 颈动脉粥样硬化 肾损害 相关性 |
| 英文关键词: Essential hypertension Ambulatory arterial stiffness index Carotid atherosclerosis Renal damage Correlation |
| 基金项目:河北省卫生厅科研基金项目（A20140269） |
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| 中文摘要: |
| 摘要 目的：探讨原发性高血压（EH）患者动态动脉硬化指数（AASI）与颈动脉粥样硬化及早期肾损害的相关性。方法：选取2017年6月~2018年5月期间我院收治的147例EH患者记为EH组，根据患者颈动脉内中膜厚度（IMT）的不同，将IMT≥1.0 mm的患者记为颈动脉硬化组（n=78），IMT＜1.0 mm的患者记为无颈动脉硬化组（n=69）；根据患者尿微量白蛋白（MAU）水平的不同，将MAU水平为0~30 mg/24 h的患者记为MAU正常组（n=86），MAU水平为30~300 mg/24 h的患者记为MAU升高组（n=61）。另选取同期于我院进行体检的健康志愿者60例记为对照组。比较EH组与对照组临床资料，比较EH患者中颈动脉硬化组、无颈动脉硬化组的AASI、颈动脉弹性功能参数，比较MAU正常组、MAU升高组的AASI、肾功能指标，采用Pearson相关性分析分析EH患者AASI与颈动脉粥样硬化及早期肾损害的相关性。结果：EH组吸烟人数、糖尿病人数、收缩压、舒张压、IMT、AASI、MAU显著高于对照组（P<0.05）。颈动脉硬化组AASI、血管压力应变弹性系数（Ep）、硬度指数均显著高于无颈动脉硬化组（P<0.05），血管顺应性（AC）明显低于无颈动脉硬化组（P<0.05）。MAU升高组AASI显著高于MAU正常组（P<0.05），PRO显著低于MAU正常组（P<0.05）；而MAU升高组与MAU正常组肾小球滤过率（GFR）、肌酐清除率（CCr）比较差异无统计学意义（P>0.05）。经Pearson相关性分析显示，EH患者中AASI与IMT、MAU、Ep、硬度指数均呈正相关性（P<0.05），与PRO、AC呈负相关（P<0.05），与GFR、CCr无相关性（P>0.05）。结论：EH患者AASI与颈动脉粥样硬化及早期肾损害情况关系密切，临床可通过监测AASI，以尽早了解患者心血管事件发生风险及靶器官损伤程度。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation between ambulatory arterial stiffness index (AASI) and carotid atherosclerosis and early renal damage in patients with essential hypertension (EH). Methods: 147 patients with EH who were admitted to our hospital from June 2017 to May 2018 were selected as EH group. According to the difference of carotid artery intima-media thickness (IMT), the patients with IMT≥1.0 mm were recorded as carotid atherosclerosis group (n=78), and the patients with IMT＜1.0 mm were recorded as non-carotid atherosclerosis group (n=69). According to the difference of urine microalbumin (MAU) level, the patients with MAU level of 0~30 mg/24 h were recorded as MAU normal group (n=86), the patients with MAU level of 30~300 mg/24 h were recorded as MAU elevation group (n=61). Another 60 healthy volunteers in our hospital during the same period were selected as control group. The clinical data of EH group and control group were compared. The AASI and carotid artery elasticity function parameters in carotid atherosclerosis group and non-carotid atherosclerosis group were compared in EH patients. The AASI and renal function indexes of MAU normal group and MAU elevation group were compared. Pearson correlation analysis was used to analyze the correlation between AASI and carotid atherosclerosis and early renal damage in EH patients. Results: The smoking number, diabetes number, systolic blood pressure, diastolic blood pressure, IMT, AASI and MAU in the EH group were significantly higher than those in the the control group (P<0.05). The AASI,pressure-strain elastic coefficient (Ep) and hardness index in the carotid atherosclerosis group were significantly higher than those in the non-carotid atherosclerosis group (P<0.05), vascular compliance (AC) was significantly lower than that in the non-carotid atherosclerosis group (P<0.05). The AASI in the MAU elevation group was significantly higher than that in the MAU normal group (P<0.05), PRO was significantly lower than that in the MAU normal group (P<0.05). But there were no significant differences in glomerular filtration rate (GFR) and creatinine clearance rate (CCr) between the MAU elevation group and the MAU normal group (P>0.05). Pearson correlation analysis showed that, there were positive correlation between AASI and IMT, MAU, Ep and hardness index in the EH patients (P<0.05), there was a negative correlation with AC, PRO (P<0.05), there were no correlation with GFR and CCr(P>0.05). Conclusion: AASI in EH patients is closely related to carotid atherosclerosis and early renal damage, the clinic can be monitored through AASI, so it can under- stand the risk of cardiovascular events and the degree of target organ injury in patients as early as possible. |
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