慢性肾脏病合并高血压患者24小时动态血压变化特点的研究

Study on changes of 24-hour dynamic blood pressure in patients with hypertension in chronic kidney disease

关键词:  高血压  肾脏病  动态血压

Key words:  hypertension  kidney disease  dynamic pressure

摘要:

［目的］观察慢性肾脏病合并高血压（HCKD）患者24 h动态血压的变化，探讨HCKD患者的血压特点。［方法］ 选择HCKD的非透析患者92例，肾功能正常的原发性高血压（EHC）患者34例，进行24 h动态血压监测，并对两组患者的24 h、日间、夜间血压平均值、血压负荷值、血压变异性和血压昼夜节律性进行统计分析。［结果］ HCKD组患者夜间SBP和DBP的血压平均值，24 h SBP和DBP、夜间SBP和DBP、日间SBP的血压负荷值，24 h、日间、夜间SBP和 DBP的变异性均明显高于EHC组，差异有统计学意义（P<0.01或P<0.05），SBP、DBP夜间下降率EHC组大于HCKD组［（11±12）% vs （2±12）%，（10±7）% vs （3±11）%］，差异有显著性意义（P<0.01）。［结论］ 夜间血压平均值、血压负荷值增高，血压变异性增大及血压昼夜节律消失是HCKD病患者的血压特点。

Abstract:

［Objective］ To observe 24-hour dynamic blood pressure variability in patients with hypertension in chronic kidney disease (HCKD). ［Methods］ Ninety-two non-dialytic patients with HCKD and 34 essential hypertension patients without renal dysfunction were divided into two groups. To record the average of 24-hour dynamic blood pressure, daytime pressure, night-time pressure, the blood pressure load, pressure variability and circadian blood pressure rhythms were recorded. ［Results］ The average blood pressure of the night-time SBP and DBP, The pressure load of 24-hour SBP and DBP, night-time SBP and DBP, daytime SBP, the 24-hour daytime, night-time blood pressure variability in HCKD group were higher than those in group of EHC. The differences were both statistically significant (P<0.01 or <0.05). The declined value of SBP and DBP of HCKD group at the night was much less than that of EHC group [(11±12)% vs (2±12)%, (10±7) % vs (3±11)%] (P<0.01). ［Conclusion］ The night-time pressure, blood pressure load and blood pressure variability in HCKD patients are increasing. The day and night rhythm change for blood pressure is disappeared.