血压昼夜节律与肾动脉阻力指数相关性研究

Research of Relation between Blood Pressure Circadian Rhythm and Renal Arterial Resistive Index

目的探讨血压昼夜节律与肾动脉阻力的相关性。方法根据24小时动态血压(ABPM)监测结果将入选病例分为杓形组(20例)和非杓形组(35例),检测空腹血糖、血脂和肌酐。应用彩色多普勒超声肾血流测定法测定两组患者左、右侧主肾动脉(MRA)、叶段动脉(SRA)的收缩期峰速度(Vs)、舒张期末血流速度(Vd),计算阻力指数(RI)。结果非杓形血压组患者肾动脉阻力指数高于杓形血压组,差异有统计学意义(P<0.05)。肾动脉平均阻力指数与夜间血压下降率呈负相关(r=-0.27,P<0.05)。结论肾动脉阻力指数与血压昼夜节律密切相关,非杓形血压可能更易引起肾动脉阻力增加。

Objective To analyze the relation between blood pressure circadian rhythm and renal arterial resistance.Methods The selected patients were divided into two groups： the nocturnal dipping group（20 cases） and the non-dipping group（35 cases） based on the 24-hour ambulate blood pressure monitoring（ABPM） profiles.Blood glucose,plasma lipids and creatinine were determined.Color Doppler ultrasound was applied to determine the renal blood flow including peak velocity in systole（Vs）,end-diastolic velocity（Vd） of main renal artery（MRA） and segmental renal artery（SRA）.Renal arterial resistive index（RI）was calculated.Results Patients in the nocturnal non-dipping group had higher MRA and SRA RI than which in the dipping group.The difference was statistically significant（P0.05）.There were negative correlation between the average renal arterial RI and the nocturnal blood pressure（r=-0.27,P0.05）.Conclusions Renal arterial RI has intimate related to blood pressure circadian rhythm.Hypertension with nocturnal non-dipping pattern will increase renal arterial resistance.