中青年难治性高血压患者小动脉重构与靶器官肾损伤的关系-东南大学学报医学版

中青年难治性高血压患者小动脉重构与靶器官肾损伤的关系

作者：杜天天¹ 2 李云¹ 庞敏³ 厉志洪⁴ 李春梅¹ 3 王雷¹ 3 骆秉铨¹ 宫海滨¹ 3

单位：1. 徐州市心血管病研究所, 江苏徐州 221009;
2. 徐州市中心医院急诊科, 江苏徐州 221009;
3. 徐州市中心医院心内科, 江苏徐州 221009;
4. 徐州市中心医院超声科, 江苏徐州 221009

分类号：R544.1;R692

出版年·卷·期（页码）：2017·36·第二期（187-191）

摘要：

目的：初步探讨中青年难治性高血压（RH）患者外周小动脉重构与亚临床靶器官肾损害的关系。方法：入选中青年（18~65岁）RH、可控性高血压（CH）及血压正常（NT）者各60例。同时检测血压、桡动脉血管超声及尿微量白蛋白肌酐比（UACR）。结果：RH组UACR、外周收缩压（SBP）、舒张压（DBP）、平均动脉压（MBP）、壁腔比、周向壁应力及平均剪切力均较CH及NT组高（P<0.05）；调整混杂因素后，在总体人群中桡动脉壁腔比与UACR、周向壁应力呈正相关，与管壁横截面积呈负相关（P<0.05）；多因素线性回归分析显示，在总体人群中桡动脉壁腔比的独立影响因素为周向壁应力、DBP、SBP及UACR。结论：中青年RH患者小动脉重构程度重于CH患者，且外周小动脉重构进一步加重靶器官肾损伤。

Objective: To evaluate the relationship between the remodeling of small peripheral artery and renal injury of subclinical target organs in young and middle-aged patients with resistant hypertension. Methods: 60 cases of young and middle-aged patients(18-65 years old) with RH, 60 cases of patients with controlled hypertension(CH) and 60 cases of normotensives(NT) were selected.All patients were performed related examinations including BP, right radial artery and UACR. Results: UACR, SBP, DBP, MBP, W/L, CS, and SS in patients with RH were higher than those in patients with CH and NT(P<0.05). After adjusting the confounding factors, there were positive relations of W/L with UACR and CS and negative relation between W/L and WCSA among the general population(P<0.05). Multi-factor linear regression analysis showed that CS, DBP, SBP, and UACR were independent risk factors for W/L in the general population(P<0.05). Conclusion: The small artery remodeling in young and middle-aged patients with resistant hypertension is more severe than that in controlled hypertension and it can accelerate the injury of kidney.

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