| Background Hypertension is a common chronic cardiovascular disease,and long-term high blood pressure can easily lead to arterial atherosclerosis,then lead to a series of atherosclerotic cardiovascular and cerebrovascular diseases.At present,the assessment of atherosclerosis is mainly based on carotid ultrasound,arterial angiography and noninvasive peripheral arteriosclerosis test and the like,however,the pathological outcome has been formed when the result is positive.In recent years,with the further study of MAU,Hypertensive patients can be complicated with MAU,and the presence of MAU suggests that high blood pressure has caused early damage to blood vessels,which can be generated early in atherosclerosis.The correlation analysis between MAU and vascular atherosclerosis indexes of patients with hypertension will help to reveal the value of MAU in predicting early atherosclerosis and has important clinical significance.Research Purpose Through the correlation analysis of MAU and carotid plague in patients with primary hypertension,to explore the relationship between MAU and atherosclerosis in hypertensive patients,and to pay more attention to the detection of MAU in the diagnosis and treatment of hypertension,Early to take effective intervention measures,reduce the death risk and disability risk of hypertension patients due to atherosclerotic cardiovascular and cerebrovascular disease.Method From February to August in 2016,Selected 359 patients with primary hypertension of clear diagnosis from Department of Cardiology,Yuxi People’s Hospital.And those patients were excluded with secondary hypertension,diabetes,renal insufficiency,cancer,infectious diseases,immune diseases and other diseases that can cause elevated Urine microalbumin.At the next morning of admission,all selected subjects were taken 10ml samples of clean midstream urine for detecting ACR.Then,we collected fasting venous blood samples to detect Glu,TC,TG,HDL-C,LDL-C,Hey,Cys-C,hs-CRP,CREA,UA.The carotid intima-media thickness,plaque size and plaque number were measured by arterial ultrasonography,and carotid plaque Crouse total score,carotid plaque grade score was calculated by the above data.According to ACR levels,the subjects were divided into normal urine protein group(ACR<30mg/g)266 cases and microalbuminuria group(30mg/g≤ACR≤300mg/g)73 cases,clinical proteinuria group(ACR>300mg/g)20 case(it is not included in the study due to the few samples).The general clinical data(sex,smoking,BMI,whether combined with coronary heart disease,),blood biochemical parameters(Glu,TC,TG,HDL-C,LDL-C,CREA,UA,Hey,Cys-C,hs-CRP),ACR level,carotid plaque Crouse total score,grade score and recent cardiovascular and cerebrovascular events(3 months)were analyzed statistically to the two groups.Results1.All the selected subjects completed the collection of general clinical data,ACR level,blood biochemical indexes and the determination of carotid atherosclerosis.2.Recent three months there was no lost situation in the follow-up visits.3.①MAU positive group are 73 cases,average age(64.48 ± 8.76)years old,35 males and 38 females,average BMI(25.09 士 3.75),57 cases of smoking,49 cases with coronary heart disease,Glu(5.07 ± 0.52)mmol/L,TC(4.08 ±0.75)mmol/L,TG(2.25±2.06)mmol/L,HDL-C(1.12±0.19)mmol/L,LDL-C(2.08±0.66)mmol/L,Cys-C(1.22±0.29)mg/L,hs-CRP(2.67±3.09)mg/L,Hcy(16.36±8.22)μmol/L,Cr(81.67±22.73)μmol/L,UA(352.49±82.88)μmol/L,ACR(76.84±57.69),Crouse total score((5.85±1.11)),grade score(4.27 ± 1.26),plaque number(4.53±1.00),27 cases of cardiovascular and cerebrovascular events occurred in recent 3 months;②MAU negative group are 266 cases,average age(65.39±11.53)years old.157 males and 109 females,average BMI(24.49±3.46),73 cases of smoking,126 cases with coronary heart disease,Glu(5.13±0.56)mmol/L,TC(4.29±1.10)mmol/L,TG(2.02±1.80)mmol/L,HDL-C(1.22±0.04)mmol/L,LDL-C(2.38±1.31)mmol/L,Cys-C(1.26±0.45)mg/L,hs-CRP(2.36±3.36)mg/L,Hey(17.83±10.69)μmol/L,Cr(85.78±21.82)μmol/L,UA(364.76±95.38)μmol/L,ACR(5.75±6.17),Crouse total score(2.09±1.40),grade score(2.16±1.12),plaque number(1.31±0.90),41 cases of cardiovascular and cerebrovascular events occurred in recent 3 months.4.There was no significant difference of the two groups were selected for the study in age,gender ratio,BMI,whether smoking,Glu,TC,TG,HDL-C,LDL-C,Cys-C,hs-CRP,Hcy,Cr,UA between the two groups(P<0.05).There was a significant difference in the ration of coronary heart disease,recent cardiovascular and cerebrovascular events,crouse total score,grade score,carotid plaque number,ACR levels between the two groups(P<0.05).5.Took the crouse total score,grade score,carotid plaque number as the dependent variable,and ACR level as an independent variable to do single factor correlation analysis.There was a positive correlation between ACR and the crouse total score,grade score,carotid plaque number(r=0.784,0.733,0.787).Further,took ACR level as an independent variable to do regression analysis,the linear regression equations were y=2.058+0.040x,y=2.060+0.026x,y=1.332+0.032x.6.Took the blood lipids level and carotid atherosclerosis to do correlation analysis in the both groups.which took the crouse total score,grade score,carotid plaque number as the dependent variable,and TC,TQ HDL-C,LDL-C as an independent variable to do single factor correlation analysis.There was a positive correlation between TC,TG,LDL-C and the crouse total score,grade score,carotid plaque number.There was a negative correlation between HDL-C and the crouse total score,grade score,carotid plaque number.7.According to the level of cholesterol levels were divided into hypercholesterolemia group(TC≥5.2mmmol/L)56 cases(11 cases had recent cardiovascular and cerebrovascular events)and non-hypercholesterolemia group(TC<5.2mmmol/L)283 cases(57 cases had recent cardiovascular and cerebrovascular events);There was no significant difference between the two groups in the recent cardiovascular and cerebrovascular events(P>0.05).In addition,According to triglyceride levels were divided into hypertriglyceridemia group(TG≥1.7mmmol/L)148 cases(30 cases had recent cardiovascular and cerebrovascular events)and non-hypertriglyceridemia group(TG<1.7mmmol/L)191 cases(38 cases had recent cardiovascular and cerebrovascular events);There was no significant difference between the two groups in the recent cardiovascular and cerebrovascular events(P>0.05).Conclusion There is a correlation between microalbuminuria and carotid atherosclerosis,coronary heart disease and cardiovascular and cerebrovascular events in hypertensive patients,and the level of microalbuminuria is positively correlated with the degree of carotid atherosclerosis,suggesting that the level of microalbuminuria can predict to an early degree of atherosclerosis,subclinical target vessel damage and recent cardiovascular and cerebrovascular events,and dyslipidemia contributed to and accelerated the process of arteriosclerosis.MAU and blood lipid levels testing in hypertensive patients and early to take effective intervention measures helps to reduce the death risk and disability risk of hypertension patients due to atherosclerotic cardiovascular and cerebrovascular disease. |
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