摘要
目的探讨盐敏感性高血压患者24h血压变化及尿钠排泄量的变化。方法采用快速静脉输注生理盐水与呋塞米排钠缩容结合的方法判定患者的盐敏感性,并根据盐敏感性判定结果将患者分为盐敏感性组(SS)及非盐敏感性组(NSS),对两组患者的24h血压变化节律进行监测,并测定两组患者的白天、夜间尿钠排泄量。结果 85例患者中出现盐敏感性患者35例,达41.2%。24h动态血压监测结果表明,两组患者的24h收缩压和舒张压、白天收缩压和舒张压差异无统计学意义(P>0.05),但SS组患者夜间收缩压、舒张压明显升高,差异具有统计学意义(P<0.05)。两组患者24h尿钠量及白天尿钠量差异均无统计学意义(P>0.05)。但SS组患者的夜间尿钠量及其在24h尿钠量中所占的比重与NSS组比较均明显上升,差异有统计学意义(P<0.01)。结论盐敏感性高血压患者出现夜间尿钠排泄量明显增加,并导致血压出现"非杓型"改变,给予利尿剂可有效缓解患者血压变异性变化。
Objective To explore correlation of variation of blood pressure in 24 hours and urinary sodium excretion in patients with salt-sensitive hypertension. Methods Salt sensitivity was determined by the method combined rapid intravenous infusion of saline with furosemide natriuresis volume reduction. According to the salt sensitivity, the patients were divided into two groups, salt-sensitive group（SS） and non-salt-sensitive group （NSS）. Variation of blood pressure and urinary sodium excretion in 24 hours were observed and detected in patients. Results 35 cases of patients（41.2% ）were salt sensitive. There were no significant differences in 24-hour blood pressure and daytime blood pressure according to the observation of variation of blood pressure. But nocturnal systolic pressure （122.8±9.1 vs 118.4± 10.3, P〈0.05） and diastolic pressure （82.6±4.9 vs 80.3±5.4, P 〈 0.05）in SS group were signifi- cantly increased. There were no significant differences in 24-hour and daytime urinary sodium excretion between two groups （ P 〉 0. 05 ）. But nocturnal urinary sodium excretion and its percentage in 24-hour urinary sodium excretion were significantly evaluated in SS group compared with NSS group （ P 〈 0.01 ）. Conclusions Nocturnal urinary sodium excretion obviously increased in patients with salt-sensitive hypertension, which resulted in ＂non-dipper＂ change in nocturnal blood pressure and can be effectively ameliorated by diuretic.
出处
《心脑血管病防治》
2015年第4期281-283,295,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
关键词
盐敏感性
高血压
血压变异性
尿钠
Salt-sensitive
Hypertension
Blood pressure variability
Urinary sodium
