慢性肾脏病患者动态血压参数与颈动脉粥样硬化的相关性研究

A Study on Relationship between Ambulatory Blood Pressure Parameters and Carotid Atherosclerosis in Patients with Chronic Kidney Disease

目的:探讨慢性肾脏病(CKD)患者动脉粥样硬化与血压昼夜节律的关系。方法:对108例CKD患者和18例对照组患者进行颈动脉超声检查和动态血压监测,分析动脉粥样硬化和血压昼夜节律的关系。结果:CKD患者与对照组相比,夜间收缩压和舒张压下降数值较小,血压呈明显的非勺形模式;存在颈动脉斑块者,血压昼夜节律异常率明显升高;相关分析显示血压节律异常与颈动脉斑块及颈动脉内膜中层厚度(IMT)有明确的相关性,相关系数0.396,P<0.05。结论:CKD患者动脉粥样硬化和血压昼夜节律异常相关,在积极降低血压值的同时,还需调整血压昼夜节律,以延缓肾功能的恶化。

Objective：To explore the relationship between atherosclerosis and abnormal blood pressure（Bp） circadian rhythm in patients with chronic kidney disease（CKD）.Methods：Carotid ultrasonography and dynamic Bp monitoring were performed in 108 CKD patients and 18 controls with primary hypertension.The relationship between atherosclerosis and Bp circadian rhythm was analyzed.Results：Compared with control group,the decline of nighttime systolic Bp and diastolic Bp was less remarkable in CKD group,and Bp presented non-spoon pattern.The rates of Bp circadian rhythm abnormality were significantly higher in patients with carotid plaques.Correlation analysis showed that Bp circadian rhythm abnormality was positively correlated with carotid intima-media thickness（IMT） and carotid plaques.Conclusions：Atherosclerosis is significantly correlated with abnormality of Bp circadian rhythm in patients with CKD.To delay the aggravation of renal function,Bp should be depressed,and Bp circadian rhythm should be regulated.