血压晨峰对早期肾脏功能影响的临床研究

The Clinical Study of Morning Blood Pressure Surge Impact on Early Renal Function

目的探讨原发性高血压患者血压晨峰(MBPS)对早期肾功能损害的影响。方法选择2011年10月至2012年10月在深圳市宝安区福永人民医院心血管内科住院的1、2级原发性高血压患者198例,将其根据血压昼夜变化特点分为MBPS组(102例)和非MBPS组(96例)。同时测定两组患者24 h动态血压和早期肾功能指标,如血清尿酸(UA)、胱抑素(CysC)、血和尿β2微球蛋白(β2-MG)、24 h微量白蛋白(24 h mAlb)的变化。结果 MBPS组24 h白昼、夜间平均收缩压、晨峰值的变异幅度均高于非MBPS组(P<0.05);MBPS组24 h尿mAlb、尿β2-MG、血清CysC、UA明显高于非MBPS组,差异有统计学意义(P<0.05)。结论原发性高血压患者血压有晨峰现象比无晨峰现象者易出现早期肾功能损害。

Objective To explore morning blood pressure surge（MBPS） impact on early renal damage of essential hypertension.Methods According to the 24-hour ambulatoryblood pressure（24h ABPM） of 198 patients with grade 1,2 of essential hypertension from cardiovascular medicine department of Fuyong People＇s Hospital of Baoan District in Shenzhen City during October 2011 and October 2012,were divided into two groups,MBPS group of 102 patients and non-MBPS group of 96 patients.The 24 h dynamic blood pressure and early renal function indexes such as serum uric acid（UA）,cystatin（CysC）,blood,urine β2-microglobulin（β2-MG）,and 24-hour microalbumin（24h mAlb） of the two groups were detected.Results The 24 h daytime and nighttime average SBP,morning peak variation rang in the MBPS group were significantly higher than the non-MBPS group（P 0.05）.The 24 hour urinemAlb,β2-MG in the urine,serum CysC and UA in the MBPS group were significantly higher than that of non-MBPS group（P 0.05）.Conclusion The MBPS group is more prone to have early renal damage than the non-MBPS group.