143例慢性肾脏病患者高血压横断面研究

Cross-sectional study of hypertension in 143 patients with chronic kidney disease

目的分析慢性肾脏病(CKD)患者的高血压患病、控制和药物治疗情况。方法回顾性横断面研究,分析143例初次就诊的CKD患者的血压,以及相关的信息资料。结果91.62%(131/143)的CKD患者伴高血压,血压控制情况不理想,初诊时仅有13.74%(18/131)的患者血压控制在130/80 mm Hg(1 mm Hg=0.133 kPa)以下。不伴高血压的CKD患者的血清肌酐(SCr)值低于伴高血压患者(P=0.007),肾小球滤过率(GFR)则相反(P=0.001)。96.18%(126/131)的患者在初诊时已使用降压药,血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体Ⅱ受体拮抗剂(ARB)的总使用率为41.98%(55/131),仅13例接受多药联用方案。结论在CKD患者中,高血压患病率高,达标率低。初诊时,大多数患者的降压药治疗方案未遵循相关指南。

Objective To analyze the prevalence of hypertension, blood pressure （BP） control and treatment in patients with chronic kidney diseases （CKD） in order to guide diagnosis and therapy. Methods Retrospective cross-sectional study, the BP records and other relative medical information were analyzed in 143 CKD patients at first visit to the nephrology clinic. Results The prevalence of hypertension is 91.62% （131/141） in CKD patients. The BP control is suboptimal, only 13.74% （18/131） of patients were on BP targets （〈130/80 mm Hg） at first visits. The serum Creatinine （SCr） were higher in CKD patients with hypertension than in those without （P=0. 007）, and estimated glomeruiar filtration rate （GFR） were opposite （P=0. 001）. 96.16% （126/131） of patients were receiving anti-hypertensive drugs at first visit. The total usage of angiotensin-converting enzyme inhibitors （ACEI） or angiotensin receptor blocker （ARB） was 41.98% （55/131）. Only 13 CKD patients were on combination treatment. Conclusions The prevalence of hypertension was high and the rate of achievement of BP target was low in CKD patients. The patterns of antihypertensive drug were not coincident with the guidelines.