摘要
目的 探讨老年高血压患者血压昼夜波动与肾小球滤过率（glomerular filtration rate,GFR）下降的关系。方法 对178例老年高血压患者测定血清肌酐，以＊censored＊roff-Gault公式计算GFR估测值（eGFR），根据eGFR≥90 ml/（min·1.72 m2）、60～89 ml/（min·1.72 m2）、40～59 ml/（min·1.72 m2）、〈40 ml/（min·1.72 m2）分为A组44例、B组59例、C组46例、D组29例，并行24 h动态血压监测,测定空腹血糖、TC、TG、LDL-C、HDL-C，计算体重指数。结果 A组、B组、C组和D组随着eGFR的下降，夜间收缩压、24 h脉压、昼间脉压、夜间脉压、收缩压晨峰逐渐升高；舒张压波动幅度、夜间收缩压下降率、夜间脉压下降率逐渐降低，差异有统计学意义（P〈0.05）。Pearson相关分析显示，病程、夜间收缩压、收缩压晨峰、24 h脉压、夜间脉压及夜间舒张压下降率与eGFR呈负相关，夜间舒张压、舒张压波动幅度、夜间收缩压下降率、夜间脉压下降率与eGFR呈正相关（P〈0.05,P〈0.01）。结论 血压昼夜节律和波动幅度的异常与eGFR下降密切相关，尤以夜间脉压增大为著。
Objective To study the correlation between circadian blood pressure fluctuation and decreased glomerular filtration rate（GFR） in elderly patients with hypertension.Methods One hundred and seventy-eight elderly patients with hypertension were enrolled in this study.Their plasma URIC was detected and estimated GFR（eGFR） was calculated following the ＊censored＊croft-Gault equation.The patients were divided into group A（n=44）,group B（n=59）,group C（n=46） and group D（n=29） according to their eGFR[≥90 ml/（min·1.72 m2）,60-89 ml/（min·1.72 m2）,40-59 ml/（min·1.72 m2）,and〈40 ml/（min·1.72 m2）].Blood pressure was dynamically monitored for 24 h and fasting plasma glucose,TC,TG,LDL-C,HDL-C,body mass index were measured.Results The nocturnal systolic blood pressure,24 h and circadian pulse pressure,morning blood pressure increased while the diastolic pressure,nocturnal systolic blood pressure and pulse pressure decreased in groups A,B,C,D（P〈0.05）.Pearson correlation analysis showed that the eGFR was negatively related with the course of disease,nocturnal and morning systolic blood pressure,decreased 24 h and nocturnal pulse pressure and positively with the nocturnal diastolic blood pressure,diastolic blood pressure fluctuation,decreased nocturnal systolic blood pressure and pulse pressure（P〈0.05）.Conclusion Circadian rhythm and fluctuation of blood pressure are closely related with decreased eGFR.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第5期472-474,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
山西省卫生厅科技攻关项目(200824)
关键词
高血压
昼夜节律
肾小球滤过率
血压监测
便携式
危险因素
hypertension
circadian rhythm
glomerular filtration rate
blood pressure monitoring,ambulatory
risk factors
