126例IgA肾病伴高血压患者血压昼夜节律异常的危险因素分析  

Risk factor analysis of blood pressure circadian rhythm abnormality in IgA nephropathy patients with hypertension

作　　者：林利容[1] 张炜炜[1] 黄坤[1] 杨聚荣[1] 张建国[1] 李开龙[1] 何娅妮[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肾脏内科,重庆400042

出　　处：《临床内科杂志》2013年第4期250-252,共3页Journal of Clinical Internal Medicine

摘　　要：目的分析IrA肾病伴高血压患者血压昼夜节律异常的危险因素。方法收集成人IgA肾病伴高血压患者126例，均行肾活检及动态血压监测，排除服用降压药物、糖皮质激素者。采用单因素及多因素Logistic回归分析血压昼夜节律异常的危险因素。结果（1）成人IgA肾病伴高血压患者非勺型血压患病率为73．8％；（2）与勺型血压组比较，非勺型血压患者总胆固醇、血尿酸、血清肌酐、尿蛋白／肌酐、夜间尿钠、尿氯排泄水平均显著增高，肾小球滤过率（eGFR）水平显著降低；（3）Logistic回归分析显示，高尿酸、尿蛋白／肌酐≥1．84mg,／mg、24小时尿钠〉62．5mmol／L、eGFR〈60ml／min／1．73m。是IgA肾病伴高血压患者血压昼夜节律异常的危险因素。结论肾脏损害不仅是导致高血压的重要原因，在血压节律调控异常中也发挥了重要作用。Objective To investigate the risk factors for blood pressure circadian rhythm abnor- mality in the IgA nephropathy （IgAN） patients with hypertension. Methods The study enrolled 126 adult IgA nephropathy patients with hypertension, all of them underwent renal biopsy and ambulatory blood pressure monitoring. Patients were excluded if they were treated by antihypertensive drugs or glucocorti- coids. Baseline patient characteristics and clinical data were collected. Risk factors of blood pressure rhythm abnormality were determined by Spearman correlation analysis and Logistic regression analysis. Results The prevalence of non-dipper blood pressure was 73.8% for IgAN patients with hypertension. Uric acid, serum creatinine, urine protein/creatinine, nocturnal urinary sodium, urinary chlorine excretion levels were higher in patients with non-dipper hypertension than those with dipper hypertension. Patients with non-dipper hypertension had significantly lower eGFR than those with non-dipper hypertension. Of lo- gistic regression analysis showed that high uric acid,urine protein/creatinine≥ 1.84 mg/mg,24 h urinary sodium 〉 62.5 mmol/L, eGFR 〈 60 ml/min/1.73 m2 were risk factors for blood pressure circadian rhythm abnormality in the IgA nephropathy patients with hypertension. Conclusion Kidney lesion not on- ly leads to hypertension, also plays a crucial role in the regulation of blood pressure rhythm abnormalities.

关 键 词：IGA肾病 非勺型血压 患病率 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]