• 四川大學華西醫(yī)院老年病科（成都，610041）;

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(nèi)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(fā)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(fā)性高血壓患者中的臨床意義. 華西醫(yī)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(fā)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(fā)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(fā)性高血壓患者24h脈壓與尿微量白蛋白的關系[J]. 山西醫(yī)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(fā)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. 1. 　王方芳, 楊冬花, 李昭屏. 微量白蛋白尿在原發(fā)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. 2. 　蔣廣恩, 黃子揚. 原發(fā)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. 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. 4. 　周英智, 馬麗娜, 馮明. 原發(fā)性高血壓患者24h脈壓與尿微量白蛋白的關系[J]. 山西醫(yī)科大學學報, 2010, 41(1): 48-49.
  5. 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. 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. 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. 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. 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. 10. 　Verdecchia P, Reboldi GP. Hypertension and microalbuminuria: the new detrimental duo[J]. Blood Press, 2004, 13(4): 198-211.
  11. 11. 　Reboldi G, Gentile G, Angeli F, et al. Microalbuminuria and hypertension[J]. Minerva Med, 2005, 96(4): 261-275.
  12. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 26. 　陳曉平, 武娟, 彭清, 等. 原發(fā)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. 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. 28. 　Viberti G. Regression of albuminuria: latest evidence for a new approach[J]. J Hypertens Suppl, 2003, 21(3): S24-S28.
  29. 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. 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. 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. 32. 　Duka I, Bakris G. Influence of microalbuminuria in achieving blood pressure goals[J]. Curr Opin Nephrol Hypertens, 2008, 17(5): 457-463.
  33. 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. 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. 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.