慢性肾脏病患者血压变异性与肾功能损伤关系的研究

Relationship between blood pressure variability and renal injury of patients with chronic kidney disease

目的分析慢性肾脏病患者血压变异性与肾功能损伤的关系。方法选取2011年7月~2015年12月收治的CKD患者255例,按照CKD分期(1~5期)将所有患者分成5组。运用携带式动态血压检测仪来监测记录患者24h的动态血压值,并对数据进行统计学分析。结果随着肾脏功能水平的逐渐下降,患者的24h平均收缩压、白昼平均收缩压、夜间平均收缩压和夜间平均舒张压逐渐升高,且差异有统计学意义(P<0.05),而24h平均舒张压、白昼平均舒张压的差异无统计学意义。在收缩压变异性参数上,CKD 4、5期患者明显高于CKD 1~3期患者,差异有统计学意义(P<0.05),但未发现舒张压变异性参数的差异有统计学意义。结论 CKD患者肾脏功能水平的下降与24h、白昼和夜间平均血压的增高、血压变异性增加以及非杓型血压比例增加等因素密切相关。

Objective To analyze the relationship between blood pressure variability and renal injury of patients with chronic kidney disease. Methods 255 cases of patients with CKD cured in our hospital from July 2011 to December 2015 were selected and divided into five groups according to the CKD staging （1 - 5）. Portable ambulatory blood pressure detector was used to detect and record the ambulatory blood pressure values of 24h. And the data were statistically analyzed. Results With the gradual decline of renal function, the mean systolic pressure, mean systolic pressure, nocturnal mean systolic blood pressure （24h） and nocturnal diastolic blood pressure （DBP） of patients were gradually increased, and the difference was statistically significant （P 〈 0.05）. However, there was no significant difference in mean diastolic pressure and mean diastolic blood pressure between 24h. In systolic blood pressure variability parameters, patients of＇CKD 4 and CKD 5 were significantly higher than those of patients with CKD from 1 to 3, the difference was statistically significant （P 〈 0.05）, but there was no significant difference in diastolic blood pressure variability parameters. Conclusion The level of kidney function decline in patients with CKD and 24h, daytime and nighttime average blood pressure, blood pressure variability increase and increase the proportion of non dipper blood pressure and other factors are closely related.