中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
3期
225-228
,共4页
王云%刘琦%秦明照%刘谦
王雲%劉琦%秦明照%劉謙
왕운%류기%진명조%류겸
高血压%肾小球滤过率%白蛋白尿
高血壓%腎小毬濾過率%白蛋白尿
고혈압%신소구려과솔%백단백뇨
Hypertension%Glomerular filtration rate%Urinary albuminuia
目的 观察老年原发性高血压患者血压变异性(blood pressure variability,BPV)指标变化,分析BPV与高血压合并肾功能损害的关系. 方法 选择127例原发性高血压并存慢性肾脏病(chronic kidney disease,CKD)患者,按美国肾脏基金会——慢性肾脏病实践指南(NKF-K/DOQI)分期分为3组:CKD2期组50例,CKD3期组40例,CKD4期组37例,行24 h动态血压监测,记录24h平均收缩压,24 h收缩压标准差,计算收缩压变异系数;分析血压指标的组间差异.分析血压指标与肾小球滤过率、尿白蛋白排泄率的相关性.分析BPV与肾功能损害的关系. 结果 CKD2期组收缩压标准差、变异系数(11.91±2.56、9.79±2.01)低于CKD3期组(13.98±2.89、11.28±1.70)及CKD4期组(14.25±3.16、11.53±2.65),均P＜0.05.24 h收缩压标准差、变异系数、24 h舒张压变异系数与肾小球滤过率呈负相关(均P＜0.01),与尿白蛋白清除率呈正相关(P＜0.01).Logistic回归分析提示24 h收缩压标准差、变异系数与肾功能损害程度相关(P＜0.05). 结论 老年高血压并存肾功能不全患者BPV随着肾损害程度加重而增加.BPV与原发性高血压肾功能损害相关.
目的 觀察老年原髮性高血壓患者血壓變異性(blood pressure variability,BPV)指標變化,分析BPV與高血壓閤併腎功能損害的關繫. 方法 選擇127例原髮性高血壓併存慢性腎髒病(chronic kidney disease,CKD)患者,按美國腎髒基金會——慢性腎髒病實踐指南(NKF-K/DOQI)分期分為3組:CKD2期組50例,CKD3期組40例,CKD4期組37例,行24 h動態血壓鑑測,記錄24h平均收縮壓,24 h收縮壓標準差,計算收縮壓變異繫數;分析血壓指標的組間差異.分析血壓指標與腎小毬濾過率、尿白蛋白排洩率的相關性.分析BPV與腎功能損害的關繫. 結果 CKD2期組收縮壓標準差、變異繫數(11.91±2.56、9.79±2.01)低于CKD3期組(13.98±2.89、11.28±1.70)及CKD4期組(14.25±3.16、11.53±2.65),均P＜0.05.24 h收縮壓標準差、變異繫數、24 h舒張壓變異繫數與腎小毬濾過率呈負相關(均P＜0.01),與尿白蛋白清除率呈正相關(P＜0.01).Logistic迴歸分析提示24 h收縮壓標準差、變異繫數與腎功能損害程度相關(P＜0.05). 結論 老年高血壓併存腎功能不全患者BPV隨著腎損害程度加重而增加.BPV與原髮性高血壓腎功能損害相關.
목적 관찰노년원발성고혈압환자혈압변이성(blood pressure variability,BPV)지표변화,분석BPV여고혈압합병신공능손해적관계. 방법 선택127례원발성고혈압병존만성신장병(chronic kidney disease,CKD)환자,안미국신장기금회——만성신장병실천지남(NKF-K/DOQI)분기분위3조:CKD2기조50례,CKD3기조40례,CKD4기조37례,행24 h동태혈압감측,기록24h평균수축압,24 h수축압표준차,계산수축압변이계수;분석혈압지표적조간차이.분석혈압지표여신소구려과솔、뇨백단백배설솔적상관성.분석BPV여신공능손해적관계. 결과 CKD2기조수축압표준차、변이계수(11.91±2.56、9.79±2.01)저우CKD3기조(13.98±2.89、11.28±1.70)급CKD4기조(14.25±3.16、11.53±2.65),균P＜0.05.24 h수축압표준차、변이계수、24 h서장압변이계수여신소구려과솔정부상관(균P＜0.01),여뇨백단백청제솔정정상관(P＜0.01).Logistic회귀분석제시24 h수축압표준차、변이계수여신공능손해정도상관(P＜0.05). 결론 노년고혈압병존신공능불전환자BPV수착신손해정도가중이증가.BPV여원발성고혈압신공능손해상관.
Objective To observe the change of blood pressure variability (BPV)in elderly hypertension patients,and to analysis the correlation between BPV and stages of renal function damage.Methods 127 elderly primary hypertensive patients with chronic kidney disease(CKD) were divided into three groups:stage 2 CKD group (aged 60-90 years,n=50),stage 3 CKD group (aged 62-93 years,n=40) and stage 4 CKD group (aged 64-94 years,n=37),according to National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (K/DOQI) guide.24 h ambulatory blood pressure monitoring (24 hABPM) was used to measure 24 h mean systolic blood pressure (24 hSBP),24 hSBP standard deviation (24 hSBPSD),and to calculate 24 hSBP coefficient of variation (24 hSBPCV).Differences in above indicators among groups were analyzed by ANOVA.The relationship between above indicators and estimated glomerular filtration rate (eGFR),urinary albumin excretion rates(UAER) were assessed by Spearman rank correlation coefficient.Logistic regression analysis was employed to assess the relationship between BPV and the degrees of impaired renal function.Results 24 h SBPSD and 24h SBPCV were lower in stage 2 CKD group than in stage 3 CKD and stage 4 CKD groups [(11.91±2.56) vs.(13.98±2.89),(14.25±3.16);(9.79±2.01)vs.(11.28± 1.70),(11.53±2.65) ;all P＜0.05].24 h SBPSD,24 h DBPCV and 24 h diastolic blood pressure (24 hdBP) CV were negatively correlated with eGFR (all P＜0.01) and were positively correlated with UAER (all P＜0.01).Logistic regression analysis showed that 24 h DBPSD and 24h SBPCV were related to impaired renal function (both P＜0.05).Conclusions Blood pressure variability is increasing along with impairing renal function in elderly hypertensive patients.Blood pressure variability is associated with renal function damage.
