微量白蛋白尿在原發性高血壓患者中的臨床意義_《華西醫學》

作者：

李君 ,  張新軍

四川大學華西醫院老年病科（成都，610041）;

關鍵詞：

原發性高血壓微量白蛋白尿尿白蛋白排泄靶器官損害血管緊張素轉換酶抑制劑血管緊張素受體拮抗劑

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微量白蛋白尿是指尿中白蛋白排泄率超過正常范圍，受血壓水平、血糖、血脂、體重等諸多因素的影響，是高血壓早期腎臟損害的標志，也是全身血管內皮細胞受損的重要標志之一。微量白蛋白尿具有重要意義，是高血壓患者心血管疾病的獨立危險因子。原發性高血壓患者應進行微量白蛋白尿篩查。

引用本文： 李君,張新軍. 微量白蛋白尿在原發性高血壓患者中的臨床意義. 華西醫學, 2012, 27(11): 1729-1732. doi: 復制

1.	王方芳, 楊冬花, 李昭屏. 微量白蛋白尿在原發性高血壓中的研究進展[J]. 中國心血管病研究, 2009, 7(4): 305-307.
2.	蔣廣恩, 黃子揚. 原發性高血壓合并微量白蛋白尿的臨床研究進展[J]. 心血管病學進展, 2007, 28(5): 682-686.
3.	Pontremoli R, Leoncini G, Ravera M, et al. Microalbuminuria, cardiovascular, and renal risk in primary hypertension[J]. J Am Soc Nephrol, 2002, 13(Suppl 3): S169-S172.
4.	周英智, 馬麗娜, 馮明. 原發性高血壓患者24h脈壓與尿微量白蛋白的關系[J]. 山西醫科大學學報, 2010, 41(1): 48-49.
5.	Cirillo M, Stellato D, Laurenzi M, et al. Pulse pressure and isolated systolic hypertension: association with microalbuminuria. The GUBBIO Study Collaborative Research Group[J]. Kidney Int, 2000, 58(3): 1211-1218.
6.	Ogunniyi MO, Croft JB, Greenlund KJ, et al. Racial/ethnic differences in microalbuminuria among adults with prehypertension and hypertension: National Health and Nutrition Examination Survey (NHANES), 1999-2006[J]. Am J Hypertens, 2010, 23(8): 859-864.
7.	Hitha B, Pappachan JM, Pillai HB, et al. Microalbuminuria in patients with essential hypertension and its relationship to target organ damage: an Indian experience[J]. Saudi J Kidney Dis Transpl, 2008, 19(3): 411-419.
8.	Peng H, Ding J, Peng Y, et al. Hyperuricemia and microalbuminuria are separately and independently associated with prehypertension among Chinese Han women[J]. Metab Syndr Relat Disord, 2012, 10(3): 202-208.
9.	Oliveras A, Armario P, Martell-Clarós N, et al. Urinary albumin excretion is associated with nocturnal systolic blood pressure in resistant hypertensives[J]. Hypertension, 2011, 57(3): 556-560.
10.	Verdecchia P, Reboldi GP. Hypertension and microalbuminuria: the new detrimental duo[J]. Blood Press, 2004, 13(4): 198-211.
11.	Reboldi G, Gentile G, Angeli F, et al. Microalbuminuria and hypertension[J]. Minerva Med, 2005, 96(4): 261-275.
12.	Redon J, Rovira E, Miralles A, et al. Factors related to the occurrence of microalbuminuria during antihypertensive treatment in essential hypertension[J]. Hypertension, 2002, 39(3): 794-798.
13.	Pascual JM, Rodilla E, Gonzalez C, et al. Long-term impact of systolic blood pressure and glycemia on the development of microalbuminuria in essential hypertension[J]. Hypertension, 2005, 45(6): 1125-1130.
14.	Herrera R, Miguel A, Chipi J, et al. Albuminuria as a marker of kidney and cardio-cerebral vascular damage. Isle of Youth Study (ISYS), Cuba[J]. MEDICC Review, 2010, 12(4): 20-26.
15.	Pontremoli R, Ravera M, Bezante GP, et al. Left ventricular geometry and function in patients with essential hypertension and microalbuminuria[J]. J Hypertens, 1999, 17(7): 993-1000.
16.	Ratto E, Leoncini G, Viazzi F, et al. Inappropriate left ventricular mass is associated with microalbuminuria independently of left ventricular hypertrophy in primary hypertension[J]. J Hypertens, 2008, 26(2): 345-350.
17.	Leoncini G, Sacchi G, Ravera M, et al. Microalbuminuria is an integrated marker of subclinical organ damage in primary hypertension[J]. J Hum Hypertens, 2002, 16(6): 399-404.
18.	Schrader J, Lüders S, Kulschewski A, et al. Microalbuminuria and tubular proteinuria as risk predictors of cardiovascular morbidity and mortality in essential hypertension: final results of a prospective long-term study (MARPLE Study)*[J]. J Hypertens, 2006, 24(3): 541-548.
19.	Färbom P, Wahlstrand B, Almgren P, et al. Interaction between renal function and microalbuminuria for cardiovascular risk in hypertension: the Nordic diltiazem study[J]. Hypertension, 2008, 52(1): 115-122.
20.	Salles GF, Cardoso CR, Pereira VS, et al. Prognostic significance of a reduced glomerular filtration rate and interaction with microalbuminuria in resistant hypertension: a cohort study[J]. J Hypertens, 2011, 29(10): 2014-2023.
21.	Berton G, Cordiano R, Mbaso S, et al. Prognostic significance of hypertension and albuminuria for early mortality after acute myocardial infarction[J]. J Hypertens, 1998, 16(4): 525-530.
22.	Tebbe U, Bramlage P, Lüders S, et al. Follow-up of cardiovascular risk markers in hypertensive patients treated with irbesartan: results of the i-SEARCH Plus Registry[J]. J Clin Hypertens (Greenwich), 2010, 12(12): 909-916.
23.	Lee M, Saver JL, Chang KH, et al. Level of albuminuria and risk of stroke: systematic review and meta-analysis[J]. Cerebrovasc Dis, 2010, 30(5): 464-469.
24.	Lee M, Saver JL, Chang KH, et al. Impact of microalbuminuria on incident stroke: a meta-analysis[J]. Stroke, 2010, 41(11): 2625-2631.
25.	Umemura T, Kawamura T, Sakakibara T, et al. Microalbuminuria is independently associated with deep or infratentorial brain microbleeds in hypertensive adults[J]. Am J Hypertens, 2012, 25(4): 430-436.
26.	陳曉平, 武娟, 彭清, 等. 原發性高血壓患者認知功能與微量白蛋白尿[J]. 中華心血管病雜志, 2008, 36(8): 722-725.
27.	Sarafidis PA, Khosla N, George LB. Antihypertensive therapy in the presence of proteinuria[J]. Am J Kidney Dis, 2007, 49(1): 12-26.
28.	Viberti G. Regression of albuminuria: latest evidence for a new approach[J]. J Hypertens Suppl, 2003, 21(3): S24-S28.
29.	Shionoiri H, Kosaka T, Kita E, et al. Comparison of long-term therapeutic effect of an ACE inhibitor, temocapril, with that of a diuretic on microalbuminuria in non-diabetic essential hypertension[J]. Hypertens Res, 2000, 23(6): 593-600.
30.	Menne J, Farsang C, Deák L, et al. Valsartan in combination with lisinopril versus the respective high dose monotherapies in hypertensive patients with microalbuminuria: the VALERIA trial[J]. J Hypertens, 2008, 26(9): 1860-1867.
31.	Cotter J, Oliveira P, Cunha P, et al. Different patterns of one-year evolution of microalbuminuria in hypertensive patients treated with different inhibitors of the renin-angiotensin system[J]. Rev Port Cardiol, 2008, 27(11): 1395-1404.
32.	Duka I, Bakris G. Influence of microalbuminuria in achieving blood pressure goals[J]. Curr Opin Nephrol Hypertens, 2008, 17(5): 457-463.
33.	Nakagawa N, Fujino T, Kabara M, et al. AngiotensinⅡ receptor blocker and long-acting calcium channel blocker combination therapy decreases urinary albumin excretion while maintaining glomerular filtration rate[J]. Hypertens Res, 2011, 34(10): 1121-1126.
34.	Galceran J, Plana J, Felip A, et al. Manidipine treatment in patients with albuminuria not sufficiently reduced with renin-angiotensin system blockers[J]. Expert Rev Cardiovasc Ther, 2010, 8(6): 751-757.
35.	Douglas K, O’malley PG, Jackson JL. Meta-analysis: the effect of statins on albuminuria[J]. Ann Intern Med, 2006, 145(2): 117-124.

1. 　王方芳, 楊冬花, 李昭屏. 微量白蛋白尿在原發性高血壓中的研究進展[J]. 中國心血管病研究, 2009, 7(4): 305-307.
2. 　蔣廣恩, 黃子揚. 原發性高血壓合并微量白蛋白尿的臨床研究進展[J]. 心血管病學進展, 2007, 28(5): 682-686.
3. 　Pontremoli R, Leoncini G, Ravera M, et al. Microalbuminuria, cardiovascular, and renal risk in primary hypertension[J]. J Am Soc Nephrol, 2002, 13(Suppl 3): S169-S172.
4. 　周英智, 馬麗娜, 馮明. 原發性高血壓患者24h脈壓與尿微量白蛋白的關系[J]. 山西醫科大學學報, 2010, 41(1): 48-49.
5. 　Cirillo M, Stellato D, Laurenzi M, et al. Pulse pressure and isolated systolic hypertension: association with microalbuminuria. The GUBBIO Study Collaborative Research Group[J]. Kidney Int, 2000, 58(3): 1211-1218.
6. 　Ogunniyi MO, Croft JB, Greenlund KJ, et al. Racial/ethnic differences in microalbuminuria among adults with prehypertension and hypertension: National Health and Nutrition Examination Survey (NHANES), 1999-2006[J]. Am J Hypertens, 2010, 23(8): 859-864.
7. 　Hitha B, Pappachan JM, Pillai HB, et al. Microalbuminuria in patients with essential hypertension and its relationship to target organ damage: an Indian experience[J]. Saudi J Kidney Dis Transpl, 2008, 19(3): 411-419.
8. 　Peng H, Ding J, Peng Y, et al. Hyperuricemia and microalbuminuria are separately and independently associated with prehypertension among Chinese Han women[J]. Metab Syndr Relat Disord, 2012, 10(3): 202-208.
9. 　Oliveras A, Armario P, Martell-Clarós N, et al. Urinary albumin excretion is associated with nocturnal systolic blood pressure in resistant hypertensives[J]. Hypertension, 2011, 57(3): 556-560.
10. 　Verdecchia P, Reboldi GP. Hypertension and microalbuminuria: the new detrimental duo[J]. Blood Press, 2004, 13(4): 198-211.
11. 　Reboldi G, Gentile G, Angeli F, et al. Microalbuminuria and hypertension[J]. Minerva Med, 2005, 96(4): 261-275.
12. 　Redon J, Rovira E, Miralles A, et al. Factors related to the occurrence of microalbuminuria during antihypertensive treatment in essential hypertension[J]. Hypertension, 2002, 39(3): 794-798.
13. 　Pascual JM, Rodilla E, Gonzalez C, et al. Long-term impact of systolic blood pressure and glycemia on the development of microalbuminuria in essential hypertension[J]. Hypertension, 2005, 45(6): 1125-1130.
14. 　Herrera R, Miguel A, Chipi J, et al. Albuminuria as a marker of kidney and cardio-cerebral vascular damage. Isle of Youth Study (ISYS), Cuba[J]. MEDICC Review, 2010, 12(4): 20-26.
15. 　Pontremoli R, Ravera M, Bezante GP, et al. Left ventricular geometry and function in patients with essential hypertension and microalbuminuria[J]. J Hypertens, 1999, 17(7): 993-1000.
16. 　Ratto E, Leoncini G, Viazzi F, et al. Inappropriate left ventricular mass is associated with microalbuminuria independently of left ventricular hypertrophy in primary hypertension[J]. J Hypertens, 2008, 26(2): 345-350.
17. 　Leoncini G, Sacchi G, Ravera M, et al. Microalbuminuria is an integrated marker of subclinical organ damage in primary hypertension[J]. J Hum Hypertens, 2002, 16(6): 399-404.
18. 　Schrader J, Lüders S, Kulschewski A, et al. Microalbuminuria and tubular proteinuria as risk predictors of cardiovascular morbidity and mortality in essential hypertension: final results of a prospective long-term study (MARPLE Study)*[J]. J Hypertens, 2006, 24(3): 541-548.
19. 　Färbom P, Wahlstrand B, Almgren P, et al. Interaction between renal function and microalbuminuria for cardiovascular risk in hypertension: the Nordic diltiazem study[J]. Hypertension, 2008, 52(1): 115-122.
20. 　Salles GF, Cardoso CR, Pereira VS, et al. Prognostic significance of a reduced glomerular filtration rate and interaction with microalbuminuria in resistant hypertension: a cohort study[J]. J Hypertens, 2011, 29(10): 2014-2023.
21. 　Berton G, Cordiano R, Mbaso S, et al. Prognostic significance of hypertension and albuminuria for early mortality after acute myocardial infarction[J]. J Hypertens, 1998, 16(4): 525-530.
22. 　Tebbe U, Bramlage P, Lüders S, et al. Follow-up of cardiovascular risk markers in hypertensive patients treated with irbesartan: results of the i-SEARCH Plus Registry[J]. J Clin Hypertens (Greenwich), 2010, 12(12): 909-916.
23. 　Lee M, Saver JL, Chang KH, et al. Level of albuminuria and risk of stroke: systematic review and meta-analysis[J]. Cerebrovasc Dis, 2010, 30(5): 464-469.
24. 　Lee M, Saver JL, Chang KH, et al. Impact of microalbuminuria on incident stroke: a meta-analysis[J]. Stroke, 2010, 41(11): 2625-2631.
25. 　Umemura T, Kawamura T, Sakakibara T, et al. Microalbuminuria is independently associated with deep or infratentorial brain microbleeds in hypertensive adults[J]. Am J Hypertens, 2012, 25(4): 430-436.
26. 　陳曉平, 武娟, 彭清, 等. 原發性高血壓患者認知功能與微量白蛋白尿[J]. 中華心血管病雜志, 2008, 36(8): 722-725.
27. 　Sarafidis PA, Khosla N, George LB. Antihypertensive therapy in the presence of proteinuria[J]. Am J Kidney Dis, 2007, 49(1): 12-26.
28. 　Viberti G. Regression of albuminuria: latest evidence for a new approach[J]. J Hypertens Suppl, 2003, 21(3): S24-S28.
29. 　Shionoiri H, Kosaka T, Kita E, et al. Comparison of long-term therapeutic effect of an ACE inhibitor, temocapril, with that of a diuretic on microalbuminuria in non-diabetic essential hypertension[J]. Hypertens Res, 2000, 23(6): 593-600.
30. 　Menne J, Farsang C, Deák L, et al. Valsartan in combination with lisinopril versus the respective high dose monotherapies in hypertensive patients with microalbuminuria: the VALERIA trial[J]. J Hypertens, 2008, 26(9): 1860-1867.
31. 　Cotter J, Oliveira P, Cunha P, et al. Different patterns of one-year evolution of microalbuminuria in hypertensive patients treated with different inhibitors of the renin-angiotensin system[J]. Rev Port Cardiol, 2008, 27(11): 1395-1404.
32. 　Duka I, Bakris G. Influence of microalbuminuria in achieving blood pressure goals[J]. Curr Opin Nephrol Hypertens, 2008, 17(5): 457-463.
33. 　Nakagawa N, Fujino T, Kabara M, et al. AngiotensinⅡ receptor blocker and long-acting calcium channel blocker combination therapy decreases urinary albumin excretion while maintaining glomerular filtration rate[J]. Hypertens Res, 2011, 34(10): 1121-1126.
34. 　Galceran J, Plana J, Felip A, et al. Manidipine treatment in patients with albuminuria not sufficiently reduced with renin-angiotensin system blockers[J]. Expert Rev Cardiovasc Ther, 2010, 8(6): 751-757.
35. 　Douglas K, O’malley PG, Jackson JL. Meta-analysis: the effect of statins on albuminuria[J]. Ann Intern Med, 2006, 145(2): 117-124.

《華西醫學》

微量白蛋白尿在原發性高血壓患者中的臨床意義

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《華西醫學》

微量白蛋白尿在原發性高血壓患者中的臨床意義

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料