中国全科医学2016，Vol.19Issue(1)：48-53,6.DOI:10.3969/j.issn.1007-9572.2016.01.009
慢性肾脏病患者24h动态血压变化特点的临床研究
Clinical Characteristics of 24 -hour Ambulatory Blood Pressure Variation in Patients With Chronic Kidney Disease
摘要
Abstract
Objective To investigate the characteristics of 24-hour ambulatory blood pressure variation of patients with chronic kidney disease ( CKD ) at different stages.Methods We enrolled 362 CKD patients who were admitted into Department of Nephrology of the First Affiliated Hospital of Xinjiang Medical University from September 2012 to September 2014.According to glomerular filtration rate (GFR), the patients were divided into 5 groups: CKD1 group (n=101), CKD2 group (n=83), CKD3 group (n=90), CKD4 group (n=56), CKD5 group (n=32) .Ambulatory blood pressure indexes and circadian rhythm of the patients of each group were monitored by portable ambulatory blood pressure monitoring (ABPM), and relevant clinical indexes were also monitored at the same time .Results CKD4 and CKD5 patients were higher than CKD1, CKD2 and CKD3 patients in 24 h-SBP, 24 h-DBP, d-SBP, d-DBP, n-SBP and n-DBP (P<0.05) .Of all the CKD patients, the patients with deep-dipper BP pattern , dipper BP pattern , non-dipper BP pattern and reversed dipper BP pattern accounted for 1.9% (7/362), 19.1% (69/362), 54.7% (198/362) and 24.3% (88/362) respectively; non-dipper BP pattern and reversed dipper BP pattern were noted in CKD 1 patients and CKD 2 patients.Patients with non -dipper BP pattern and reversed dipper BP pattern were higher in n-SBP, n-DBP and night pulse pressure and lower in the decrease rates of night diastolic pressure and night systolic pressure than patients with dipper BP pattern ( P <0.05 ) .Patients with 24 h urine microalbumin>300 mg were higher than patients with 24 h urine microalbumin <30 or between 30 ~300 mg in 24 h-SBP, 24 h-DBP, d-SBP, d-DBP, n-SBP and n-DBP (P<0.05) .Conclusion With the decline of renal function in patients with CKD, their hypertension increase and non -dipper and reversed dipper BP patterns take the majority , and circadian rhythm appears at the early stage of CKD; systolic and diastolic blood pressure increase with the elevation of urine microalbumin .关键词
慢性肾脏病/血压监测,便携式/昼夜节律Key words
Chronic kidney disease/Blood pressure monitoring/ambulatory/Circadian rhythm分类
医药卫生引用本文复制引用
赵鑫,热西旦·扎克尔,黄萱,张双艳,桑晓红,王梅红,刘健,李素华..慢性肾脏病患者24h动态血压变化特点的临床研究[J].中国全科医学,2016,19(1):48-53,6.基金项目
新疆维吾尔自治区自然科学基金资助项目(2013211A091)——新疆维吾尔族CRP基因多态性与慢性肾脏病的相关研究 （2013211A091）
