發(fā)布時(shí)間：2018-01-15 12:35

  本文關(guān)鍵詞：原發(fā)性高血壓患者尿微量白蛋白與左心室損害及血管內(nèi)皮功能的相關(guān)性研究　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 原發(fā)性高血壓 尿微量白蛋白 血管內(nèi)皮功能 相關(guān)性 左心室質(zhì)量

【摘要】：目的:探討原發(fā)性高血壓患者尿微量白蛋白與左心室損害及血管內(nèi)皮功能的相關(guān)性。方法:隨機(jī)選擇2012年10月-2013年10月來我院行高血壓治療的門診就診的患者60例,作為觀察組。觀察組進(jìn)一步分為尿微量白蛋白(MAU)陽性組和MAU陰性組,另選擇同期來我院行健康體檢者20例,作為對照組。對三組入選后一天內(nèi)行24h尿微量白蛋白(MAU)、內(nèi)皮依賴性血流介導(dǎo)的血管舒張功能的檢測(EDF)、左心室、頸動(dòng)脈內(nèi)膜中層厚度(c-IMT)超聲檢查。結(jié)果:1三組肱動(dòng)脈內(nèi)皮依賴性舒張功能(EDF)的比較:MAU陽性組、MAU陰性組、對照組肱動(dòng)脈靜息狀態(tài)直徑分別為(3.98±0.62)mm、(4.12±0.50)mm,(4.13±0.63)mm、MAU陽性組、MAU陰性組、對照組肱動(dòng)脈反應(yīng)性充血直徑分別為(4.29±0.76)mm、(4.47±0.64)mm、(4.56±0.75)mm,MAU陽性組的血流介導(dǎo)的血管擴(kuò)張反應(yīng)(FMD)明顯低于對照組(7.29±3.12%vs 10.13±3.07%),P0.05,而MAU陰性組和正常對照組之間并未見到統(tǒng)計(jì)學(xué)差異,P0.05,NS組間無明顯差異。2三組頸動(dòng)脈內(nèi)膜中層厚度(c-IMT)的比較:MAU陽性、MAU陰性組、正常對照組頸動(dòng)脈內(nèi)膜中層厚度分別為(0.85±0.15mm)、(0.78±0.15mm)、(0.75±0.17mm),對照組和MAU陽性組之間比較,P0.05,MAU陰性組和MAU陽性組之間比較,P0.05。3三組左心室質(zhì)量(LVM)和左心室質(zhì)量指數(shù)(LVMI)的比較:結(jié)果顯示MAU陽性組明顯高于正常對照組LVM(166.99±17.71 vs143.70±16.57、LVMI 103.91±12.92 vs 84.13±11.27),P0.05;MAU陽性組也高于MAU陰性組,LVM(166.99±17.71 vs 149.24±15.74、LVMI103.91±12.92 vs 87.15±11.19),P0.05;而MAU陰性組和正常對照組之間,無統(tǒng)計(jì)學(xué)差異。結(jié)論:1 FMD和尿微量白蛋白之間存在線性相關(guān),且隨著尿微量白蛋白的增加,FMD呈下降趨勢。2 c-IMT和尿微量白蛋白之間存在線性相關(guān),且隨著尿微量白蛋白的增加,c-IMT的厚度相應(yīng)增加。3左心室質(zhì)量指數(shù)(LVMI)和尿微量白蛋白之間存在線性相關(guān),且隨著尿微量白蛋白的增加,左心室質(zhì)量指數(shù)也相應(yīng)增加。4尿微量白蛋白可作為預(yù)測心臟、血管內(nèi)皮受損的指標(biāo),作為可靠的臨床檢驗(yàn)指標(biāo)對高血壓早期腎損害嚴(yán)重程度進(jìn)行預(yù)測,對微量白蛋白尿的早期檢測及盡早采取相關(guān)干預(yù)措施,以延緩腎臟病變進(jìn)展速度以及心腦血管性疾病的發(fā)生發(fā)展。
[Abstract]:Objective: to investigate the relationship between urinary microalbumin and left ventricular damage and vascular endothelial function in patients with essential hypertension. From October 2012 to October 2013, 60 outpatients who were treated with hypertension in our hospital were randomly selected. As the observation group, the observation group was further divided into positive group and MAU negative group, and 20 cases were selected for health examination in the same period. As the control group, the three groups were treated with 24 h urinary microalbuminuria (MAU), endothelium-dependent blood flow mediated vasodilation (EDF) and left ventricle (LV). Results the comparison of endothelium-dependent diastolic function (EDF) of brachial artery in three groups was made. In the control group, the diameter of brachial artery in resting state was 3.98 鹵0.62mg, 4.12 鹵0.50m / mm and 4.13 鹵0.63m / mm respectively. The reactive hyperemia diameter of brachial artery in MAU negative group and control group was 4.29 鹵0.76 mm and 4.47 鹵0.64 mm respectively, and the diameter of brachial artery reactive hyperemia in control group was 4.56 鹵0.75 mm. The FMD-mediated vasodilation response in MAU positive group was significantly lower than that in control group (7.29 鹵3.12 vs 10.13 鹵3.07) (P0.05). However, there was no statistical difference between the MAU negative group and the normal control group. 2 there was no significant difference between the three groups in carotid intima-media thickness (c-IMT). The intima-media thickness of carotid artery in MAU negative group and normal control group was 0.85 鹵0.15mm and 0.78 鹵0.15mm respectively (0.75 鹵0.17mm). The comparison between the control group and the MAU positive group was compared between the P0.05-MAU negative group and the MAU positive group. Comparison of left ventricular mass (LVM) and left ventricular mass index (LVMI) in the three groups: the results showed that the MAU positive group was significantly higher than that of the normal control group (. 166.99 鹵17.71 vs143.70 鹵16.57. LVMI 103.91 鹵12.92 vs 84.13 鹵11.27P0.05; MAU positive group was also higher than MAU negative group 166.99 鹵17.71 vs 149.24 鹵15.74. LVMI103.91 鹵12.92 vs 87.15 鹵11.19 P 0.05; There was no significant difference between the MAU negative group and the normal control group. Conclusion there is a linear correlation between urinary microalbumin and urine microalbumin with the increase of urinary microalbumin.Conclusion there is a linear correlation between the MAU negative group and the normal control group. There was a linear correlation between FMD and urinary microalbumin in decreasing trend, and with the increase of urinary microalbumin. There was a linear correlation between the thickness of c-IMT and urinary microalbumin. 3. There was a linear correlation between left ventricular mass index (LVMII) and urinary microalbumin, and with the increase of urinary microalbumin. The left ventricular mass index (LVMI) was also increased accordingly. Urinary microalbuminuria could be used as a predictor of heart and vascular endothelial damage and as a reliable clinical test index to predict the severity of early renal damage in hypertensive patients. Early detection of microalbuminuria and early intervention measures were taken to delay the progression of renal disease and the occurrence and development of cardiovascular and cerebrovascular diseases.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.11

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