摘要
目的探讨中老年原发性高血压(EH)患者合并冠心病和尿微量蛋白(MAU)对动脉弹性的影响。方法选择中老年EH患者246例,按年龄分为中年EH组114例,老年EH组132例,其中未经治疗的合并冠心病44例(中老年各22例,按冠状动脉病变支数和年龄分为中年单支病变9例、双支病变9例、3支病变4例;老年单支病变8例、双支病变6例、3支病变8例)。选择同期无高血压的门诊体检者45例为正常对照组。检测患者MAU/肌酐(ACR)。采用动脉硬化仪检测入选者的颈-股动脉脉搏波传导速度(CF-PWV)、肱踝脉搏波传导速度(ba-PWV)和中心动脉收缩压(CSP)。结果中年EH组和老年EH组ACR(P<0.05)、冠心病患病率(19.30%和16.67%vs0%,P<0.05)显著高于正常对照组。老年单、双、3支病变ba-PWV、ACR显著高于中年(P<0.05);中年和老年3支病变CSP、CF-PWV、ba-PWV、ACR显著高于单、双支病变患者(P<0.05)。多元线性回归显示,年龄、CF-PWV、CSP与中、老年EH患者MAU和冠状动脉变病支数呈正相关(P<0.05,P<0.01)。结论 CF-PWV、CSP在一定程度上反映中老年EH患者冠状动脉病变和肾损害程度,合并冠状动脉病变时,老年患者肾血管损害加重。
Objective To study the effect of microalbuminuria（MAU）on artery elasticity in middle-aged and elderly essential hypertension（EH）patients with CHD.Methods Two hundred and forty-six EH patients were divided into middle-aged EH group（n=114）and elderly EH group（n=132）with 45 EH-free subjects undergoing physical examination served as a control group.The CF-PWV,Ba-PWV and CSP in patients included in this study were measured with an arteriosclerosis detector.Results The volume of ACR and incidence of CHD were significantly higher in middle-aged and elderly EH groups than in control group（19.30% and 16.67% vs 0%,P〈0.05）.The number of 1-,2-and 3-branch lesions was significantly greater,the ba-PWV and ACR volume were significantly higher in elderly EH group than in middle-aged EH group（P〈0.05）.The number of 3-branch lesions was significantly greater,the CSP,CF-PWV,ba-PWV and ACR volume were significantly higher in middle-aged and elderly EH groups with 3-branch lesions than in those with 1-and 2-branch lesions（P〈0.05）.Multivariate linear regression analysis showed that age,CF-PWV,CSP,MAU were positively associated with the number of coronary artery lesions（P〈0.05,P〈0.01）.Conclusion CF-PWV and CSP can show the severity of CHD and renal damage.The renal vascular damage is exacerbated in elderly EH patients with CHD.
作者
肖金翠
刘大男
李治菁
Xiao Jincui;Liu Danan;Li Zhijing(Cuizhou Medical University, Cuiyang 550004, Cuizhou Province, Chin)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2018年第5期483-486,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(81660083)
贵州省社会发展攻关项目[黔科合SY(2013)3017号]
贵州省高层次创新型人才培养计划[黔科合人才(2015)4026号]
贵州省对外合作项目[黔科合省合(2011)7001号]
贵州省优秀青年科技人才培养对象专项资金项目[黔科合人字(2011)26号]
关键词
高血压
冠心病
蛋白尿
动脉硬化
hypertension
coronary disease
proteinuria
arteriosclerosis
作者简介
通信作者：刘大男，Email：Liudanan2000@sina．com
