中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2015年
1期
19-23
,共5页
布海霞%程李涛%张爱华%汪涛%王悦%范敏华
佈海霞%程李濤%張愛華%汪濤%王悅%範敏華
포해하%정리도%장애화%왕도%왕열%범민화
肾功能不全,慢性%高血压%单纯收缩期高血压
腎功能不全,慢性%高血壓%單純收縮期高血壓
신공능불전,만성%고혈압%단순수축기고혈압
Renal insufficiency,chronic%Hypertension%Isolated systolic hypertension
目的 探讨慢性肾脏病(CKD)患者中单纯收缩期高血压(ISH)与CKD分期的关系.方法 选择CKD患者626例,按血压类型分为:正常血压、单纯舒张期高血压(IDH)、ISH和双期高血压(SDH).观察4种血压亚型在CKD各期的百分比.结果 在CKD 1、2、3、4、5期,IDH患病率分别为9.1％、6.7％、2.9％、3.1％和4.1％;ISH患病率分别为0、9.2％、23.9％、28.6％和37.0％;SDH患病率分别为4.5％、8.4％、8.0％、17.3％和21.9％;血压控制率逐渐下降,分别为86.4％、75.6％、65.3％、51.0％和37.0％(P＜0.05);多因素回归分析结果显示,年龄、糖尿病和CKD分期为发生ISH的独立危险因子.与CKD 1～2期比较,CKD 3、4、5期发生ISH的OR值分别为2.388、2.697和5.980.结论 CKD患者肾功能受损的的程度与ISH进展一致.
目的 探討慢性腎髒病(CKD)患者中單純收縮期高血壓(ISH)與CKD分期的關繫.方法 選擇CKD患者626例,按血壓類型分為:正常血壓、單純舒張期高血壓(IDH)、ISH和雙期高血壓(SDH).觀察4種血壓亞型在CKD各期的百分比.結果 在CKD 1、2、3、4、5期,IDH患病率分彆為9.1％、6.7％、2.9％、3.1％和4.1％;ISH患病率分彆為0、9.2％、23.9％、28.6％和37.0％;SDH患病率分彆為4.5％、8.4％、8.0％、17.3％和21.9％;血壓控製率逐漸下降,分彆為86.4％、75.6％、65.3％、51.0％和37.0％(P＜0.05);多因素迴歸分析結果顯示,年齡、糖尿病和CKD分期為髮生ISH的獨立危險因子.與CKD 1～2期比較,CKD 3、4、5期髮生ISH的OR值分彆為2.388、2.697和5.980.結論 CKD患者腎功能受損的的程度與ISH進展一緻.
목적 탐토만성신장병(CKD)환자중단순수축기고혈압(ISH)여CKD분기적관계.방법 선택CKD환자626례,안혈압류형분위:정상혈압、단순서장기고혈압(IDH)、ISH화쌍기고혈압(SDH).관찰4충혈압아형재CKD각기적백분비.결과 재CKD 1、2、3、4、5기,IDH환병솔분별위9.1％、6.7％、2.9％、3.1％화4.1％;ISH환병솔분별위0、9.2％、23.9％、28.6％화37.0％;SDH환병솔분별위4.5％、8.4％、8.0％、17.3％화21.9％;혈압공제솔축점하강,분별위86.4％、75.6％、65.3％、51.0％화37.0％(P＜0.05);다인소회귀분석결과현시,년령、당뇨병화CKD분기위발생ISH적독립위험인자.여CKD 1～2기비교,CKD 3、4、5기발생ISH적OR치분별위2.388、2.697화5.980.결론 CKD환자신공능수손적적정도여ISH진전일치.
Objective To investigate the relationship between the prevalence of isolated systolic hypertension (ISH) and the stages of chronic kidney disease (CKD) in chronic kidney disease outpatient clinic.Methods CKD patients of stages 1,2,3,4 and 5 were recruited (n=626).Based on office systolic pressure (SBP) and diastolic pressure (DBP),they were classified into four subtypes:normotension (＜ 140/90 mmHg),isolated diastolic hypertension (IDH,SBP ＜ 140 mmHg and DBP ≥ 90 mmHg),ISH (SBP≥ 140 mmHg and DBP ＜ 90 mmHg) and systolic-diastolic hypertension (SDH,SBP≥140 mmHg and DBP≥90 mmHg).Results The control rate of blood pressure was 86.4％,75.6％,65.3％,51.0％ and 37.0％ at CKD stage 1,2,3,4 and 5,respectively,which decreased with the advancement of CKD.There was a stepwise increase in the prevalence of ISH (0,9.2％,23.9％,28.6％ and 37.0％ at CKD stage 1,2,3,4 and 5,respectively) and SDH (4.5％,8.4％,8.0％,17.3％,21.9％ at CKD stage 1,2,3,4 and 5,respectively).Logistic regression analysis showed that age,diabetes and CKD stages were independent predictors of ISH.Compared with CKD stage 1-2,CKD stage 3,4 and 5 showed 2.388,2.697 and 5.980 folds risk in developing ISH.Conclusion The prevalence of ISH increases correspondingly with the advancement of stages of CKD,which may partially contribute to the increased cardiovascular mortality during the progress of CKD.
