摘要
目的探讨原发性高血压（EH）患者认知功能损害与微量白蛋白尿的关系。方法采集200例体检高血压病患者的一般资料，测量血压、身高、体重，测定空腹血糖，空腹胰岛素，总胆固醇，甘油三酯，餐后2h血糖，餐后2h胰岛素及尿蛋白，对尿蛋白阴性的患者再测定尿微量白蛋白和尿肌酐，最后评价患者的危险分层。根据国际通用的简易智力状况量表（mini mental state examination，MMSE）得分进行认知功能评定，按国际标准24分为分界值，将患者分为2组：〉24分为认知功能正常组，≤24分为认知功能障碍组。结果200例EH患者，尿蛋白阳性25例，尿蛋白阴性175例。卡方检验结果提示，尿蛋白阳性与尿蛋白阴性患者之间认知功能差异无统计学意义（P〉0．05）；175例患者测定尿微量白蛋白，进行单因素分析，结果显示：年龄、文化程度、职业、吸烟史、冠心病史、脑血管病史、危险分层、尿微量白蛋白与尿肌酐比值、餐后2h胰岛素、胆固醇及舒张压11个因素在认知功能正常组和认知功能障碍组之间的差异有统计学意义（P〈0．05）；对175例患者进行logistic多因素回归分析显示，与认知功能下降有关的指标是：文化程度、危险分层及尿微量白蛋白。结论本研究的EH人群文化程度、危险分层和尿微量白蛋白与认知功能降低密切相关，而微量白蛋白尿独立于其他危险因素与认知功能障碍的发生有关，提示微量白蛋白尿可能是认知功能障碍的独立危险因素。
Objective To study the relationship between microalbuminuria and cognitive impairment in primary hypertensive patients. Methods A total of 200 hypertensive patients were included in this study. Blood pressure, body height and weight, total cholesterol, triglyceride, fasting plasma glucose, 2 hour-postprandial blood sugar, insulin level and urine protein were measured. Microalbuminuria and urine creatinine were determined in patients without proteinuria. The risk stratification of hypertension was evaluated. The cognitive function and calculate scores were tested by the Mini Mental State Examination （MMSE） and patients were divided into two groups： 〉24-scores were classified as normal cognition group, ≤ 24-scores as impaired cognition group. Results Among the 200 hypertensive patients, proteinuria was detected in 25 patients. There was no significant difference in the cognitive function between patients with and without proteinuria （P 〉 0. 05 ）. There were significant differences on age, educational level, occupation, smoking, history of coronary heart disease, history of cerebrovascular disease, the risk stratification of hypertension, microalbuminuria./creatinine ratio, postprandial insulin level, cholesterol and diastolic blood pressure between normal cognition function group and impaired cognition function group （ all P 〈 0. 05 ）. Multivariate logistic regression analysis showed that microalbuminuria, educational level and the risk stratification of hypertension were significantly correlated to cognition impairment （ all P 〈 0. 05 ）. Conclusions Educational level, the risk stratification of hypertension and microalbuminuria are associated with cognitive impairment in this patient cohort.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2008年第8期722-725,共4页
Chinese Journal of Cardiology
基金
卫生部心防办中国高血压相关危险因素调查项目基金资助项目
关键词
高血压
认知障碍
白蛋白尿
Hypertension
Cognition disorders
Albuminuria
