糖尿病肾病腹膜透析患者的动态血压和血压变异性研究  

Blood Pressure Variation of Hypertensive Diabetic Nephropathy Patients Undergoing Peritoneal Dialysis

作　　者：钟慧[1] 刘芳[1] 沙朝晖[1] 唐晓红[1] 秦敏[1] 周雪丽[1] 任英[1] 唐鸿彬 付平[1] 

机构地区：[1]四川大学华西医院肾脏内科,成都610041 [2]重庆市潼南县人民医院内科,潼南402660

出　　处：《四川大学学报（医学版）》2012年第3期429-433,共5页Journal of Sichuan University(Medical Sciences)

摘　　要：目的分析和探讨糖尿病肾病腹膜透析患者的动态血压和血压变异性。方法纳入40岁以上均在本院接受腹膜透析治疗3月以上的高血压患者,根据原发病分为糖尿病肾病腹透组(n=20)和慢性肾小球肾炎腹透组(n=20),收集两组患者的基本资料、腹膜转运特性和透析充分性指标,比较两组动态血压和血压变异性指标。结果两组患者的基本资料、透析充分性和残余肾功能差异无统计学意义。两组患者的平均收缩压、舒张压及平均动脉压差异无统计学意义。糖尿病肾病腹透患者收缩压变异性指包括24h和白天收缩压均值的标准差及变异系数大于慢性肾小球肾炎患者(P<0.05)。结论 40岁以上糖尿病肾病伴高血压的腹膜透析患者的血压变异性大于同龄的慢性肾小球肾炎患者伴高血压的腹膜透析患者。Objective To investigate the variance of blood pressure of hypertensive diabetic patients undergoing continuous ambulatory peritoneal dialysis（CAPD）.Methods Twenty hypertensive CAPD patients older than 40 years with diabetic nephropathy（DN-PD group） and twenty patients with chronic glomerular nephritis（CGN-PD group） were recruited.Peritoneal status and dialysis adequacy of the patients in the two groups were calculated using PD Adequest.All patients were given 24-hour ambulatory blood pressure monitoring（ABPM）.Parameters of blood pressure variation were calculated and compared between the two groups,which included 24 h systolic and diastolic blood pressure variability（24 h SBPV/DBPV） and coefficient of variation（24 h SBPCV/24 h DBPCV）,daytime systolic and diastolic blood pressure variability（dSBPV/ DBPV） and coefficient of variation（dSBPCV/dDBPCV）,and night time systolic and diastolic blood pressure variability（nSBPV/ DBPV） and coefficient of variation（nSBPCV/nDBPCV）.Results No significant differences in clinical characteristics were found between the two groups of patients,except for fast glucose.No significant differences in average systolic and diastolic blood pressures,average pulse pressure and mean 24 h,daytime,and nighttime arterial pressures were found between the two groups.However,the DN-PD group had significantly higher 24 h SBPV,24 h SBPCV,dSBPV and dSBPCV than the CGN-PD group（P0.05）.Conclusion Hypertensive diabetic nephropathy patients undergoing peritoneal dialysis have greater blood pressure variance than those with hypertensive chronic glomerular nephritis,despite a similar result of blood pressure control.

关 键 词：糖尿病 腹膜透析 血压变异 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]