慢性肾脏病住院患者合并高血压的临床研究

Clinical study on inpatients with chronic kidney disease and hypertension

目的研究慢性肾脏病(CKD)住院患者合并高血压的临床特征。方法采用横断面+回顾性的流行病学研究方法,调查2009年11月—2010年2月上海交通大学医学院附属仁济医院肾脏科住院CKD患者的高血压患病、知晓、治疗和控制比例,研究危险因素及降压药物使用情况。2015年6—8月通过电话问卷回访调查CKD合并高血压患者的血压控制情况,有无不良事件发生。结果共纳入住院CKD患者439名,合并高血压的患病比例为69.5%(305/439),知晓比例为95.4%(291/305),治疗比例为92.8%(283/305),高血压控制比例为36.4%(111/305)。住院CKD合并高血压患者中61.3%(187/305)需要使用1种以上降压药治疗。5年后的随访发现,血压未达标患者不良事件的发生比例显著高于血压达标患者(P<0.001)。结论1CKD患者的高血压患病比例高,患者的高血压知晓及治疗比例高,但是高血压的达标比例较低。2多数CKD患者需要应用1种以上降压药物来控制血压。3有效控制血压能显著减少不良事件的发生。

Objective To investigate the clinical characteristics of inpatients with chronic kidney disease（CKD）and hypertension.Methods A cross-sectional and retrospective epidemiological study was carried out.The rates of incidence,awareness,treatment,and control of hypertension of inpatients with CKD admitted by the Department of Nephrology of Renji Hospital,Shanghai Jiao Tong University School of Medicine from November2009 to February 2010 were surveyed and risk factors and the use of antihypertensive drugs were investigated.The control of hypertension and adverse events of patients with CKD and hypertension was surveyed by telephone from June to August 2015.Results A total of 439 patients with CKD were enrolled.The rates of incidence,awareness,treatment,and control of hypertension were 69.5%（305/439）,95.4%（291/305）,92.8%（283/305）,and 36.4%（111/305）,respectively.61.3%（187/305） of inpatients with CKD and hypertension were administrated with more than one antihypertensive drug.Follow-up after 5 years revealed that the rate of adverse events of patients with poor control of hypertension was significantly higher than that of patients with well control of hypertension（P〈0.001）.Conclusion①The rates of incidence,awareness,and treatment of hypertension of patients with CKD are high,while the rate of well control of hypertension is low.②Most patients with CKD use more than one antihypertensive drug to control the blood pressure.③Well control of hypertension can remarkably reduce the incidence of adverse events.