摘要
目的探讨血和尿中的生化指标在老年原发性高血压患者肾功能损害诊断中的应用价值。方法根据内生肌酐清除率将278例原发性老年高血压患者分为单纯高血压组118例和高血压肾病组160例,以100例健康体检老年人作为对照组。检测各组人群血C-反应蛋白(C-reactive protein,CRP)、尿酸(uric acid,UA)、肌酐(creatinine,Cr)、尿素氮(urea nitrogen,BUN)、α_1-微球蛋白(α_1-microglobulin,α_1-MG)、β_2-微球蛋白(β_2-microglobulin,β_2-MG)和尿微量白蛋白(micro-albumin,MA)、α_1-MG、β_2-MG,并对结果进行组间比较。结果高血压肾病组血和尿所有检测指标均明显高于另外2组,差异有统计学意义(P<0.05);单纯高血压组血CRP、UA、α_1-MG和尿α_1-MG明显高于对照组,差异有统计学意义(P<0.05)。结论血CRP、UA、α_1-MG和尿α_1-MG能有效监测老年原发性高血压患者早期肾损伤。
Objective To explore the application value of biochemical indexes in blood and urine in the diagnosis of renal function damage in elderly patients with essential hypertension(EH). Methods A total of 278 patients with essential hypertension were divided into the simple hypertension group(118 cases) and hypertensive nephropathy group(160 cases) according to their Ccr, and 100 elderly healthy physical examination cases were selected as control group. The levels of blood C-reactive protein(CRP), uric acid(UA), creatinine(Cr), urea nitrogen(BUN), α_1-microglobulin(α_1-MG), β_2-microglobulin(β_2-MG) and urine micro-albumin(MA), α_1-MG, β_2-MG were detected and analyzed of the three groups. Results The results of all biochemical indexes in blood and urine of hypertensive nephropathy group were significantly higher than that of other two groups, with the difference statistically significant(P<0.05). The results of blood CRP, UA, α_1-MG and urine α_1-MG of simple hypertension group were significantly higher than that of control group, with the difference statistically significant(P<0.05). Conclusion Blood CRP, UA, α_1-MG and urine α_1-MG level patients can effectively monitor early renal function damage in elderly essential hypertension.
引文
[1] 鲁晓迪,周郁秋,王月枫,等.高血压急症相关危险因素[J].中华高血压杂志,2018,26(1):25-28.
[2] 王继光.老年高血压现状与问题[J].中国循环杂志,2017,32(11):1049-1051.
[3] 阮志芹,李华.原发性高血压和肾功能减退的相关性[J].中华高血压杂志,2017,25(1):22-26.
[4] 高瑛,黄强,蔡瑞,等.老年高血压病患者肾小球滤过率和心率变异性的关系[J].心脑血管病防治,2014,14(5):410-412.
[5] 郑华波,刘承云.老年人高血压前期的治疗研究进展[J].中国老年学杂志,2018,38(2):998-1000.
[6] 田野,张永军.老年高血压和并发症的防治[J].中国医药科学,2011,1(9):54-55.
[7] 蔡婷,黄晓玲,曾雁冰,等.中国居民高血压的危险因素Meta分析[J].现代预防医学,2015,42(5):831-836.
[8] 高金钗,彭伟.原发性高血压病因、危险因素及治疗研究进展[J].河北北方学院学报:自然科学版,2016,32(2):44-53.
[9] 程馨缘,魏丹霞.高血压早期肾损害中西医结合研究进展[J].云南中医中药杂志,2016,37(2):70-75.
[10] 宋喆.高血压性肾脏病的发病机理与诊断治疗[J].临床医药文献电子杂志,2018,61(4):12064-12066.
[11] 魏恒,张华,张化明,等.高血压脑出血患者血清CRP及IL-6变化及临床意义[J].中国临床神经外科杂志,2014,19(6):348-350.
[12] 梅艳,倪淑明,李治国.原发性高血压患者心血管危险因素对动脉弹性的影响[J].中国现代医学杂志,2016,26(2):94-97.
[13] 李少刚,郭欢.高血压前期患者血尿酸水平与早期肾损伤的关系[J].中国药物与临床,2017,17(3):327-329.
[14] 茅肖娜,高国生,沈洁琼,等.尿蛋白和尿酶联合检测在糖尿病肾病早期诊断中的应用价值[J].中国卫生检验杂志,2017,27(18):2636-2638.
[15] 陈孝倩,廖俊捷,吕吟秋,等.尿酶与微量蛋白联合检测在早期肾损伤诊断中的应用价值[J].中国卫生检验杂志,2013,23(14):2934-2936.