Correlation Analysis Between Pulse Pressure And Microalbuminuria In Patients With Coronary Heart Disease Or Merging Essential Hypertension

Objective: Atherosclerosis is a Body-wide disease,it Mainly implicates Major and medium tension blood vessel. Coronary heart disease (CHD) is because the blood vessel supply to the heart is significant atherosclerotic vascular stenosis, obstruction or spasm, that coronary insufficiency, cardiac ischemia or infarction. Atherosclerosis is a systemic disease. Is its main end point event and one of causes of death. Many epidemiology research and the large-scale clinical test confirmed that, the blood vessel structure and the function change and the heart blood vessel of brain disease occurrence and the prognosis have the extremely close relationship, therefore regarding positively knew and controls the cardiovascular disease dangerous factor, thus delays or blocks disease advancement to have the significant clinical value.The kidney is one of target organs which the primary hypertension mainly implicates, the same atherosclerosis pathological change also is one kind of body-wide disease, the coronary artery pathological change and kidney arteriosis abnormal coexisting, all is the whole body atherosclerosis partial performance.The domestic and foreign multitudinous research confirmed that, the micro albumin urine (MAlb) is the kidney blood vessel and the kidney capillaries pathological change keen target, also is the whole body blood vessel pathological change early performance, not only is the early performance which kidneys and so on hypertension, diabetes harm, moreover also is the cardiovascular event has the independent dangerous factor. The pulse pressure (PP) synthesized had reflected the blood vessel inherent elasticity and the dynamic elasticity, appraised the angiosclerosis. But the artery stiff increase also displays for artery expanding reduces, the arteries differential pressure increases; But the PP increases increases the artery to pull pulls, and easy to send the internal membrane damage, thus intensifies again atherosclerosis pathological change occurrence development. as the research prompt, the PP is the heart brain kidney target tube pathological change has and the serious degree optimum prediction factor.Not only the PP increases the width with CHD, the hypertension occurrence close correlation, but simultaneously the PP increases also may cause the kidney high irrigation, the harm renal glomerulus basilar membrane, the early time is the performance for the urine micro protein excretion rate (UAE) increase.This experiment through to CHD and merge patients with elevated blood pressure PP and UAE relevant research, whether the discussion PP can take forecast these disease early time kidney harm the target, more direct-viewing provides the early warning signal, ahead of time examines and prevents the occurrence and disease itself progress which these disease kidney harms.Methods: Chooses from December, 2006 to October, 2007 at the Second Hospital affiliated HeBei Medical University inpatient and outpatient with CHD patients or the patients with essential hypertension altogether 123 examples, 69 males, 54 females; with average age of 63.19±9.62 years; All patients were divided into two groups of CHD patients (60) and patients accompanied with hypertension (63).All of them meet the corresponding criteria.We measured blood pressure by the standard mercury column type sphygmomanometer . The PP is difference value that systolic pressure(SBP) subtracts diastolic pressure(DBP).All were divided into two groups by the PP> 55mmHg group and≤55mmHg group .The collection object of study 24 hours urine, determine the total amount of urine, remains according to the standard takes the specimen; Selects the BeckmanArray360 completely automatic scattering turbidity meter and necessary urinates the MA immunity turbidity determination reagent, uses the immunity turbidimetric method according to the standard step determination. In the 30~300mg/24h, or the rate of discharge in 20~200μg/min decides as masculine gender of UAE.Statistical analysis: Obtains the data to use the mean value±standard deviation( x±s) to express.Carries on the statistical analysis using statistical analysis software SPSS10.0, the statistical method during two groups compares uses the T-test, during the multi-groups in the examination variance homogeneity next variance analysis. To understands various parameters and UAE whether or not the linear relations line of Spearman correlation analysis.The multi-group sample rate comparison uses the x2 examination. Using Logistic regression analysis the pulse pressure (PP), systolic pressure (SBP), diastolic pressure (DBP) various parameters and UAE relations.(P<0.05 has significance for difference)Result: During three groups, presses PP≤55mmHg and the >55mmHg grouping counts various parameters situation, the group of PP≤55mmHg compares the sex, the age does not have the significance difference (P>0.05), the SBP, PP and the UAE level all have the remarkable advance in the high PP group than the low PP group, and also the statistical is of difference remarkable (P<0.05), DBP non-statistics significance, the two group of same PP levels various parameters comparison does not have the difference (P>0.05); The correlation analyses with the various targets of 3 groups with the UAE demonstrated that separately PP and UAE are connected obviously, r=0.854, P<0.01, SBP r value is 0.545, P<0.01, but DBP have not remarkable difference (P>0.05). According to the blood pressure, SBP, DBP and PP were devided with different standard and compared its UAlb gender rate ,the result is that it is only of remarkable difference between the high PP group and the low PP group, and UAlb gender rate respectively is 42.9% and 8.7%, P<0.01. But other three groups does not have the statistical significance (P>0.05); Take UAE as the dependent variable, and SBP, DBP, PP and so on various parameters as independent variable, and line the factors Logistic gradually regression analysis, the result discovered PP is the independence dangerous factor which affects UAE, OR=1.024, P<0.001, but SBP, DBP and other targets have not demonstrated the relevance.Conclusion: Compared between the patients with CHD and CHD with essential hypertension, the UAE level have not remarkable difference, the CHD patient of PP>55mmHg group compare with the PP≤55mmHg, discovered that PP has the remarkable correlational dependence with the UAE, which prompts the higher PP has the obvious related value with the CHD merning early time kidney harm; According to the blood pressure, the SBP, the DBP and the PP allover be devided two groups by different standard and be compared separately, only the groups depending PP has significance difference with the Ualb gender rate; Multi-factor Logistic gradually regression demonstrated that PP affects the UAE in the independence level, but SBP, DBP have not the relevance. Prompting PP is forecast CHD patient early time kidney harms independence dangerous factor.