中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
13期
1486-1489
,共4页
黄向阳%王英%孟晓燕%张敏%谭鹤长%宋雪霞%刘春晓%罗春明
黃嚮暘%王英%孟曉燕%張敏%譚鶴長%宋雪霞%劉春曉%囉春明
황향양%왕영%맹효연%장민%담학장%송설하%류춘효%라춘명
肾功能不全,慢性%肾小球滤过率%血压监测,便携式
腎功能不全,慢性%腎小毬濾過率%血壓鑑測,便攜式
신공능불전,만성%신소구려과솔%혈압감측,편휴식
Renal insufficiency,chronic%Glomerular filtration rate%Blood pressure monitoring,ambulatury
目的:探讨不同阶段慢性肾脏病(CKD)患者动态血压的变化规律。方法选择2012年7-12月广西医科大学第四附属医院住院及门诊收治的 CKD 患者149例,根据肾小球滤过率(GFR)分组,GFR≥60 ml·min -1·(1.73 m2)-1为早期组(n =46)、15 ml·min -1·(1.73 m2)-1≤GFR ﹤60 ml·min -1·(1.73 m2)-1为中期组(n =54)、GFR ﹤15 ml·min -1·(1.73 m2)-1为晚期组(n =49);将该院同期30例体检健康者作为对照组。分别测量各组受试者诊室血压及24 h 动态血压,记录相关指标进行比较分析。结果149例 CKD 患者中诊室血压升高58例(38.9%),24 h 动态血压升高74例(49.7%),非杓型血压91例(61.1%)。4组受试者诊室血压升高、动态血压升高及非杓型血压发生率比较:晚期组均高于中期组,中期组均高于早期组,早期组均高于对照组(P ﹤0.05)。日间平均收缩压(dSBP)、日间平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)比较:晚期组均高于中期组,中期组均高于早期组,早期组均高于对照组( P ﹤0.05);夜间血压下降率比较:晚期组均低于中期组,中期组均低于早期组,早期组均低于对照组(P ﹤0.05)。结论 CKD 患者中高血压发生率较高且控制不良,不同阶段CKD 患者的血压升高程度及非杓型血压发生率随着肾功能减退逐渐升高。
目的:探討不同階段慢性腎髒病(CKD)患者動態血壓的變化規律。方法選擇2012年7-12月廣西醫科大學第四附屬醫院住院及門診收治的 CKD 患者149例,根據腎小毬濾過率(GFR)分組,GFR≥60 ml·min -1·(1.73 m2)-1為早期組(n =46)、15 ml·min -1·(1.73 m2)-1≤GFR ﹤60 ml·min -1·(1.73 m2)-1為中期組(n =54)、GFR ﹤15 ml·min -1·(1.73 m2)-1為晚期組(n =49);將該院同期30例體檢健康者作為對照組。分彆測量各組受試者診室血壓及24 h 動態血壓,記錄相關指標進行比較分析。結果149例 CKD 患者中診室血壓升高58例(38.9%),24 h 動態血壓升高74例(49.7%),非杓型血壓91例(61.1%)。4組受試者診室血壓升高、動態血壓升高及非杓型血壓髮生率比較:晚期組均高于中期組,中期組均高于早期組,早期組均高于對照組(P ﹤0.05)。日間平均收縮壓(dSBP)、日間平均舒張壓(dDBP)、夜間平均收縮壓(nSBP)、夜間平均舒張壓(nDBP)比較:晚期組均高于中期組,中期組均高于早期組,早期組均高于對照組( P ﹤0.05);夜間血壓下降率比較:晚期組均低于中期組,中期組均低于早期組,早期組均低于對照組(P ﹤0.05)。結論 CKD 患者中高血壓髮生率較高且控製不良,不同階段CKD 患者的血壓升高程度及非杓型血壓髮生率隨著腎功能減退逐漸升高。
목적:탐토불동계단만성신장병(CKD)환자동태혈압적변화규률。방법선택2012년7-12월엄서의과대학제사부속의원주원급문진수치적 CKD 환자149례,근거신소구려과솔(GFR)분조,GFR≥60 ml·min -1·(1.73 m2)-1위조기조(n =46)、15 ml·min -1·(1.73 m2)-1≤GFR ﹤60 ml·min -1·(1.73 m2)-1위중기조(n =54)、GFR ﹤15 ml·min -1·(1.73 m2)-1위만기조(n =49);장해원동기30례체검건강자작위대조조。분별측량각조수시자진실혈압급24 h 동태혈압,기록상관지표진행비교분석。결과149례 CKD 환자중진실혈압승고58례(38.9%),24 h 동태혈압승고74례(49.7%),비표형혈압91례(61.1%)。4조수시자진실혈압승고、동태혈압승고급비표형혈압발생솔비교:만기조균고우중기조,중기조균고우조기조,조기조균고우대조조(P ﹤0.05)。일간평균수축압(dSBP)、일간평균서장압(dDBP)、야간평균수축압(nSBP)、야간평균서장압(nDBP)비교:만기조균고우중기조,중기조균고우조기조,조기조균고우대조조( P ﹤0.05);야간혈압하강솔비교:만기조균저우중기조,중기조균저우조기조,조기조균저우대조조(P ﹤0.05)。결론 CKD 환자중고혈압발생솔교고차공제불량,불동계단CKD 환자적혈압승고정도급비표형혈압발생솔수착신공능감퇴축점승고。
Objective To explore the variation characteristics of ambulatory blood pressure(ABP)at different stages of chronic kidney disease(CKD). Methods A total of CKD 149 patients admitted to this hospital from July to December in 2012 were divided,according to glomerular filtration rate( GFR),into groups A〔 at early stage,n = 46,GFR≥60 ml· min - 1 ·(1. 73 m2 )- 1〕,B〔at medium stage,n = 54,15 ml·min - 1 ·(1. 73 m2 )- 1 ≤GFR ﹤ 60 ml·min - 1 ·(1. 73 m2 )- 1〕,C〔at terminal stage,n = 49,GFR ﹤ 15 ml·min - 1 ·(1. 73 m2 )- 1 〕. And 30 healthy subjects were enrolled as control group. Clinic blood pressure(BP),24 h ambulatory blood pressure(ABP)were measured,related indicators were ana-lyzed comparatively. Results In the 149 patients,58 had increased clinic BP(38. 9% ),74 had increased ABP(49. 7% ), 91 had non - dipper BP(61. 1% ). The incidences of increased BP,ABP,non - dipper BP were higher in group C than in group B,higher in group B than in group A,higher in group A than in group control(P ﹤ 0. 05). The mean daytime SBP and DBP,mean nighttime SBP and DBP were higher in group C than in group B,higher in group B than in group A,higher in group A than in group control(P ﹤ 0. 05). The BP decrease rate was lower in group C than in group B,lower in group B than in group A,lower in group A than in group control(P ﹤ 0. 05). Conclusion The hypertension incidence is high and poorly controlled in CKD patients. The BP level and non - dipper BP incidence increase gradually with renal dysfunction.