• 1.四川大學(xué)華西醫(yī)院老年病科,四川成都 610041;2.解放軍452醫(yī)院干部空勤科,四川成都 610000;

目的:探討老年原發(fā)性高血壓(EH)患者早期腎損害指標(biāo)微量白蛋白尿(MAU)和動(dòng)脈粥樣硬化的早期征象頸動(dòng)脈內(nèi)中膜厚度(C-IMT)之間的關(guān)系。方法:99名老年EH患者按尿白蛋白/肌酐比值(ACR)分為異常ACR組和正常ACR組,對兩組的C-IMT、斑塊發(fā)生率、ACR水平及血中尿素氮(Bun)、肌酐(Cr)、總膽固醇(TC)、甘油三酯(TG)、血糖(Glu)、體重指數(shù)(BMI)等進(jìn)行分析和比較。結(jié)果:異常ACR組的年齡、尿酸、ACR、C-IMT、24小時(shí)平均收縮壓,平均動(dòng)脈壓及脈壓均高于正常ACR組(P lt;0.05);且C-IMT與ACR水平呈正相關(guān)(P lt;0.05)。結(jié)論:微量白蛋白尿和頸動(dòng)脈IMT密切相關(guān),提示微量白蛋白尿不僅和老年高血壓腎臟病變有關(guān),也是亞臨床期動(dòng)脈粥樣硬化的早期標(biāo)志.

引用本文： 張燕,張俊琦,鐘梁. 老年高血壓病患者微量白蛋白尿和動(dòng)脈粥樣硬化的關(guān)系分析. 華西醫(yī)學(xué), 2009, 24(3): 657-660. doi: 復(fù)制

1. 謝秀梅,李志凌,李兢,等.老年原發(fā)性高血壓微量白蛋白尿與血管內(nèi)皮功能及頸總動(dòng)脈粥樣硬化[J].高血壓雜志,2006,14(2):94-96..
2. BARGHOUTI N,ELKELES R,NICOLAIDES A,et al.The ultrasonic evaluation of the carotid intimamedia thickness and its relation to risk factors of atherosclerosis in normal and diabetic population[J].Int Angiol,1997,16(1):50-54..
3. 《中國高血壓防治指南》修訂委員會(huì)/高血壓的危險(xiǎn)分層.中國高血壓防治指南2005年修訂版[s].北京:人民衛(wèi)生出版社,2006:15..
4. SALONNEN JI,SALONEN R.Ultrasound Bmode imaging in observational studies of atherosclerotic progression[J].Circulation,1993,87(3 Suppl):1156-1157..
5. DEVEREUX RB,LUTAS EM,CASALE PN,et al.Standardization of Mmode echocardiography left ventricular anatomic measurements[J].J Am Coll Cardiol,1984,4(6):1222-1230..
6. BIGAZZI R,BIANCHI S,CAMPESE VM,et al.Prevalence of microalbuminuria in a large population of patients with mild to moderate essential hypertension[J].Nephron,1992,61:94-97..
7. JAY PG,GEORGE LB.Microalbuminuria:marker of vascular dysfunction,risk factor for cardiovascular disease [J].Vascular Med,2002,7:35-43..
8. KLAUSEN K,BORCHJOHNSEN K,FELDTRASMUSSEN B,et al.Very low levels of microalbuminuria are associated with increased riskof coronary heart disease and death independently of renal function,hypertension,and diabetes[J].Circulation,2004,110(1):32-35..
9. KRISTIAN W,HANS I,MICHAEL H,et al.Albuminuria and cardiovascular risk in hypertensive patients with left ventricular hypertrophy:the LIFE study[J].Kidney Int Suppl,2004,66(92):S56S58.
10. 張曉梅,胡肇衡,梁紅,等.微量白蛋白尿不同測定方法的比較[J].Chinese Journal of Medicinal Guide,2007,9:186-188..
11. LANGE LA,BOWDEN DW,LANGEFELD CD,et al.Heritability of carotid artery intimamedial thickness in type 2 diabetes [J].Stroke,2002,33(7):1876-1881..
12. JORGENSEN L,JENSSEN T,JOHNSEN SH,et al.Albuminuria as risk factor for initiation and progression of carotid atherosclerosis in nondiabetic persons:the Tromso Study [J].Eur Heart J,2007,28(3):363-369..
13. GERSTEIN HC,MANN JF,POGUE J,et al.Prevalence and determinants of microalbuminuria in high risk diabetic and no diabetic patients in heart outcomes prevention evaluation study[J].The HOPE Study Investigators.Diabetes Care,2000,23(supple 2):B35-39..
14. VIBERTI G,WHEELDON NM,MARVAL STUDY INVESTIGATORS.Microalbumihuria reduction with Vallarta in patients with type 2 diabetes mellitus:a blood pressureindependent effect[J].Circulation,2002,106(6):643-645..
15. 鄧先金,曾學(xué)豐,繆世海,等.苯那普利與依貝沙坦聯(lián)合用藥對高血壓患者尿蛋白、血肌酐清除率,血肌酐的影響[J].高血壓雜志,2004,12:400-403..
16. SEGURA J,RUILOPE LM,RODICIO JL.Microalbuminuria[J].Clin Exp Hypertens,2004,26:701-707..
  1. 1. 謝秀梅,李志凌,李兢,等.老年原發(fā)性高血壓微量白蛋白尿與血管內(nèi)皮功能及頸總動(dòng)脈粥樣硬化[J].高血壓雜志,2006,14(2):94-96..
  2. 2. BARGHOUTI N,ELKELES R,NICOLAIDES A,et al.The ultrasonic evaluation of the carotid intimamedia thickness and its relation to risk factors of atherosclerosis in normal and diabetic population[J].Int Angiol,1997,16(1):50-54..
  3. 3. 《中國高血壓防治指南》修訂委員會(huì)/高血壓的危險(xiǎn)分層.中國高血壓防治指南2005年修訂版[s].北京:人民衛(wèi)生出版社,2006:15..
  4. 4. SALONNEN JI,SALONEN R.Ultrasound Bmode imaging in observational studies of atherosclerotic progression[J].Circulation,1993,87(3 Suppl):1156-1157..
  5. 5. DEVEREUX RB,LUTAS EM,CASALE PN,et al.Standardization of Mmode echocardiography left ventricular anatomic measurements[J].J Am Coll Cardiol,1984,4(6):1222-1230..
  6. 6. BIGAZZI R,BIANCHI S,CAMPESE VM,et al.Prevalence of microalbuminuria in a large population of patients with mild to moderate essential hypertension[J].Nephron,1992,61:94-97..
  7. 7. JAY PG,GEORGE LB.Microalbuminuria:marker of vascular dysfunction,risk factor for cardiovascular disease [J].Vascular Med,2002,7:35-43..
  8. 8. KLAUSEN K,BORCHJOHNSEN K,FELDTRASMUSSEN B,et al.Very low levels of microalbuminuria are associated with increased riskof coronary heart disease and death independently of renal function,hypertension,and diabetes[J].Circulation,2004,110(1):32-35..
  9. 9. KRISTIAN W,HANS I,MICHAEL H,et al.Albuminuria and cardiovascular risk in hypertensive patients with left ventricular hypertrophy:the LIFE study[J].Kidney Int Suppl,2004,66(92):S56S58.
  10. 10. 張曉梅,胡肇衡,梁紅,等.微量白蛋白尿不同測定方法的比較[J].Chinese Journal of Medicinal Guide,2007,9:186-188..
  11. 11. LANGE LA,BOWDEN DW,LANGEFELD CD,et al.Heritability of carotid artery intimamedial thickness in type 2 diabetes [J].Stroke,2002,33(7):1876-1881..
  12. 12. JORGENSEN L,JENSSEN T,JOHNSEN SH,et al.Albuminuria as risk factor for initiation and progression of carotid atherosclerosis in nondiabetic persons:the Tromso Study [J].Eur Heart J,2007,28(3):363-369..
  13. 13. GERSTEIN HC,MANN JF,POGUE J,et al.Prevalence and determinants of microalbuminuria in high risk diabetic and no diabetic patients in heart outcomes prevention evaluation study[J].The HOPE Study Investigators.Diabetes Care,2000,23(supple 2):B35-39..
  14. 14. VIBERTI G,WHEELDON NM,MARVAL STUDY INVESTIGATORS.Microalbumihuria reduction with Vallarta in patients with type 2 diabetes mellitus:a blood pressureindependent effect[J].Circulation,2002,106(6):643-645..
  15. 15. 鄧先金,曾學(xué)豐,繆世海,等.苯那普利與依貝沙坦聯(lián)合用藥對高血壓患者尿蛋白、血肌酐清除率,血肌酐的影響[J].高血壓雜志,2004,12:400-403..
  16. 16. SEGURA J,RUILOPE LM,RODICIO JL.Microalbuminuria[J].Clin Exp Hypertens,2004,26:701-707..