血压昼夜节律异常与肾损害的相关性研究  

Research on Relationship between Circadian Blood Pressure Variation and Renal Damage

作　　者：李利华[1] 周莉[2] 李萌[2] 何义明[2] 高云光[2] 

机构地区：[1]大理学院附属医院心内科,云南省大理市671000 [2]大理学院附属医院功能科,云南省大理市671000

出　　处：《中国全科医学》2011年第8期837-839,共3页Chinese General Practice

基　　金：国家自然科学基金项目(30960137);大理学院青年教师基金

摘　　要：目的探讨血压昼夜节律异常与肾损害的关系。方法收集2004—2008年在我院内一科进行过24 h动态血压监测的住院患者的动态血压数据及相关资料,并进行统计分析。结果 242例患者根据夜间收缩压较日间收缩压下降幅度分为杓型85例(35.1%),非杓型103例(42.6%),反杓型42例(17.4%),超杓型12例(4.9%),4型患者的血尿素氮、血肌酐水平间差异均有统计学意义(P值分别为0.004和0.003),而血尿酸水平间差异无统计学意义(P=0.22)。进一步分析发现,仅在高血压患者中,4型患者的血肌酐水平间差异有统计学意义(P=0.02);而在血压正常者中,4型患者的血肌酐水平间差异无统计学意义(P=0.18)。结论高血压患者的血压昼夜节律异常与肾脏损害有关,以反杓型和超杓型者最为显著。Objective To investigate the relationship between circadian rhythm of blood pressure and renal damage..Methods Clinical data of patients who underwent 24h ambulatory blood pressure monitoring from 2004 to 2008 in medical department of our hospital were collected and analyzed. Results In the 242 inpatients,there was significant difference between dippers（n=85）,non-dippers（n=103）,reverse dippers（n=42） and extreme dippers（n=12） in serum urea nitrogen and creatinine（P0.05）,but there was no significant difference in blood uric acid（P=0.22）.Further analysis showed that statistical difference in creatinine between the four types of patients was only shown in hypertensive patients（P=0.02）,but no difference was shown in those who had normal blood pressure（P=0.18）. Conclusion Abnormal circadian rhythm of blood pressure is associated with renal damage in hypertensive,with adverse dippers and extreme dippers having the most serious renal damage.

关 键 词：动态血压监测 昼夜节律 肾损害 动脉硬化 

分 类 号：R544[医药卫生—心血管疾病] R692[医药卫生—内科学]