原发性肾病综合征儿童交感活性与24h动态血压的关系  

Sympathetic nervous system level and ambulatory blood pressure in children with primary nephrotic syndrome

作　　者：徐志泉[1] 易著文[1] 党西强[1] 吴小川[1] 曹艳[1] 黄丹琳[1] 莫双红[1] 何小解[1] 

机构地区：[1]中南大学湘雅二医院小儿肾脏病研究室,长沙410011

出　　处：《中南大学学报（医学版）》2010年第7期693-698,共6页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(30672251)~~

摘　　要：目的:探讨原发性肾病综合征(PNS)患儿动态血压(ABP)的异常变化和交感神经系统(SNS)活性及两者之间的关系。方法:对114例PNS儿童测ABP和随机血压(CBP),24 h尿去甲肾上腺素(NA)、肾上腺素(A)和多巴胺(DA)水平,并与ABP进行相关分析。结果:114例PNS儿童动态血压升高101例(88.6%),轻重度隐匿性高血压45例(39.5%),非杓型血压80例(70.2%)。收缩压(SBP)指数与负荷大于舒张压(DBP)。24 h尿NA,A和DA水平高于正常健康对照儿童。SNS水平与血压指数、血压负荷呈明显正相关,与夜间下降率呈明显负相关。结论:24 h动态血压监测发现PNS儿童高血压发病率高,非杓型血压、隐匿性高血压比例高;可以建立重度隐匿性高血压分类法;PNS儿童交感活性明显升高,可能是促使血压水平、血压负荷升高和夜间下降率减低的重要发病机制之一。Objective To explore the change in ambulatory blood pressure monitoring（ABPM） value and the sympathetic nervous system（SNS） level in children with primary nephrotic syndrome（PNS） and their relationship.Methods ABPM and casual blood pressure（CBP） were tested in 114 children with PNS and 12 normal children as a control group.The 24-h urine noradrenaline（NA）,adrenaline（A） and dopamine（DA） content were detected through high-performance liquid chromatography with electrochemical luminescence and the correlation with ABP was analyzed.Results Among 114 children with PNS,101 had elevated blood pressure（88.6%）,45 showed high incidence of masked hypertension（39.5%）,and 80 non-dipper blood pressure（70.2%）.Systolic blood pressure level and blood pressure load were greater than diastolic blood pressure.NA,A,and DA levels of the PNS group were significantly higher than those of the control group,while those of the elevated blood pressure group were significantly higher than those of the normal blood pressure group in PNS children.SNS levels were positively correlated with blood pressure levels and blood pressure load,and negatively correlated with night BP decreasing rates.Conclusion Children with PNS have high incidence of hypertension with large proportion of masked hypertension and non-dipper blood pressure.Severe masked hypertension classification should be set up.In PNS children,SNS activity is elevated that might evaluate the blood pressure level and decrease blood pressure circadian rhythm.

关 键 词：原发性肾病综合征 动态血压监制 交感神经系统 儿童 

分 类 号：R726.9[医药卫生—儿科]