Early Lesion Of Rentanl Function In Elderly Patients With Dipper Essential Hypertension And MBPS,and The Value In Detection Of Hcy And Hs-CRP

Objective To find out early lesion of rentanl function in elderly patients with dipper essential hypertension and morning blood pressure surge(MBPS), and to find out the value of homocysteine(Hcy) with high-sensitivity C reactive protein (hs-CRP)in detecting early lesion of rentanl function in hypertensive patients.Methods Select frome April 2012 to February 2014 in Department of Cardiology, Provincial Hospital Affiliated to Anhui Medical University diagnosed elderly patients with dipper essential hypertension,eligible patients were 168 cases(72 men and 96 wonen).There were 168 patients aged by 60-91y(mean age 74.78±7.09). Totally 168 elderly paritents with dipper essential hypertension were divided into MBPS group(≥35mmhg, observation group, n=73) and non-MBPS group (<35mmhg. control group, n=95) according to the MBPS of 24h amblulatory blood pressure monitoing The Cystatin C(Cys C), urinary microcalbumin (U-mAlb), urinary transferring(U-TRF), Hcy, hs-CRP,serum creatinine(SCr), blood urea nitrogen(BUN), blood glucose (Glu), cholesterol(TCH), triglyceride(TG), high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C) were tested. Then these data were run to compare to find the differences of the two groups. A database was builted by SPASS 17.0 on quality examination data. Continuous variables were represented by x±s and analyzed by t test of variance; categorical variables were represented by the numble of cases and percentage and dates were compared using the chi-square or Fisher’s exact test, and relationships of dates were discribed by the relation analysis of Person. A p-value of less than 0.05 was recognized significant.Results1. There were no statistical concernments in SCr, BUN, GLu, TCH, TG,HDL-C,and LDL-C between the two groups (P> 0.05). The amplitude of variation in morning systolic pressure peak was higher in MBPS group than in non-MBPS group[(31.8± 6.2)mmhg vs (14.2±5.0)mmhg, P=0.000]. The obvious variety in the Cys C was higher in MBPS group than in non-MBPS group[1.55±0.35vs1.18±0.29, P=0.000]. The chear variety in the Hcy was higher in MBPS group than in non-MBPS group[15.69±2.62vs12.82.±3.24, P=0.000]. The evident variety in the hs-CRP was higher in MBPS group than in non-MBPS group[4.44±2.12vs2.18±1.20. P=0.000]. According to the relation analysis of Person, Cys C had a linear relationship with Hcy and hs-CRP.± in wich Hcy showed a positive correlation (r=0.641, P< 0.01), and hs-CRP also showed a positive correlation (r=0.627, P< 0.01).2. The U-mAlb positive incidence was higher in MBPS group than in non-MBPS group(x2=18.014, P=0.000). The U-TRF positive incidence was higher in MBPS group than in non-MBPS group(x2=19.694, P=0.000).Conclusions MBPS has a great effect on Cys C, U-mAlb, U-TRF, Hcy and hs-CRP. MBPS is apt to cause early lesion of rental function in elderly patients with dipper essential hypertension. And Hcy and hs-CRP can be used to diagnosis the early renal insufficiency.