James M A, Fotherby M D, Potter J F
University Department of Medicine for the Elderly, Glenfield Hospital, Leicester, UK.
J Hypertens. 1994 Mar;12(3):309-14.
To examine the short-term reproducibility of urinary albumin measurements and the relation of urinary albumin excretion to the clinic and ambulatory blood pressure levels in elderly untreated hypertensive subjects.
Outpatient hypertension clinic of a District General Hospital.
The within-patient reproducibility of 24-h urinary microalbumin and electrolyte excretion and relation to 24-h and clinic blood pressure levels.
Sixty-four untreated elderly hypertensives (mean age 74.7 years, range 64-82) with systolic blood pressure > or = 160 mmHg or diastolic blood pressure > or = 95 mmHg, or both, were recruited from general practitioner clinics and current outpatient attenders. The patients had not received antihypertensive treatment for at least 4 weeks.
The clinic and 24-h non-invasive ambulatory blood pressures were recorded with a simultaneous 24-h urine collection for measurement of the urinary albumin and electrolyte excretion. Thirty-seven subjects performed two consecutive 24-h urine collections for an assessment of the short-term reproducibility of the albumin and electrolyte excretion.
The coefficient of variation of 24-h urinary albumin excretion was 62%, and for the albumin:creatinine ratio 52%, compared with 19% for sodium and 15% for potassium excretion. The urinary albumin excretion correlated with clinic systolic blood pressure (r = 0.33, P = 0.01) and with 24-h ambulatory systolic (r = 0.48, P < 0.001) and diastolic (r = 0.32, P = 0.01) blood pressure. The subjects with microalbuminuria (24-h urinary albumin excretion in the range 30-300 mg) had higher clinic and ambulatory blood pressures than those with lower levels of albumin excretion.
The low day-to-day intrasubject reproducibility in the 24-h urinary albumin excretion considerably reduces the potential value of single collections in the assessment of microalbuminuria in elderly hypertensives. The urinary albumin excretion correlates with the clinic and 24-h ambulatory blood pressures in elderly hypertensives.
研究老年未治疗高血压患者尿白蛋白测量的短期可重复性，以及尿白蛋白排泄与诊室血压和动态血压水平的关系。
某地区综合医院门诊高血压诊所。
患者体内24小时尿微量白蛋白和电解质排泄的可重复性，以及与24小时血压和诊室血压水平的关系。
从全科医生诊所和当前门诊就诊者中招募了64例未治疗的老年高血压患者（平均年龄74.7岁，范围64 - 82岁），收缩压≥160 mmHg或舒张压≥95 mmHg，或两者均符合。患者至少4周未接受抗高血压治疗。
记录诊室血压和24小时无创动态血压，同时收集24小时尿液以测量尿白蛋白和电解质排泄。37名受试者连续进行两次24小时尿液收集，以评估白蛋白和电解质排泄的短期可重复性。
24小时尿白蛋白排泄的变异系数为62%，白蛋白/肌酐比值为52%，而钠排泄的变异系数为19%，钾排泄的变异系数为15%。尿白蛋白排泄与诊室收缩压（r = 0.33，P = 0.01）、24小时动态收缩压（r = 0.48，P < 0.001）和舒张压（r = 0.32，P = 0.01）相关。微量白蛋白尿患者（24小时尿白蛋白排泄量在30 - 300 mg范围内）的诊室血压和动态血压高于白蛋白排泄量较低的患者。
24小时尿白蛋白排泄的受试者日内可重复性低，大大降低了单次收集尿液在评估老年高血压患者微量白蛋白尿方面的潜在价值。老年高血压患者的尿白蛋白排泄与诊室血压和24小时动态血压相关。
