原发性高血压患者血压昼夜节律对肾功能损害的相关性研究  

Study on the relationship between the circadian rhythm and renal injury in patients with primary hypertension

作　　者：林涛[1] 苏琪[2] 张姝兰[2] 

机构地区：[1]大连市友谊医院肾内科,辽宁大连116001 [2]大连市中心医院心电图科,辽宁大连116033

出　　处：《大连医科大学学报》2013年第2期157-159,共3页Journal of Dalian Medical University

摘　　要：目的观察原发性高血压病患者血压昼夜节律对肾功能损伤的影响。方法对171例轻中度原发性高血压病患者根据夜间平均血压较日间平均血压下降的幅度,分为年龄、性别无明显差异的杓型和非杓型两个组。应用24 h动态血压监测和24 h尿微量白蛋白及肾功能生化测定,观察比较昼夜节律对肾功能损伤的影响。结果两组患者24 h SBP和DBP、日间SBP和DBP的血压平均值比较,差异无显著性意义(P>0.05);夜间SBP和DBP的血压平均值比较差异有显著性意义(P<0.05);夜间下降率比较差异有显著性意义(P<0.01),杓型组与非杓型组分别为收缩压下降率(13.29±4.21)%、(4.05±3.64)%,舒张压下降率(14.50±3.56)%、(2.63±3.61)%;24 h尿微量白蛋白差异有显著性意义(P<0.01),杓型组与非杓型组分别为(87.97±12.96)mg/24 h和(110.10±27.21)mg/24 h;血压夜间下降率与尿蛋白的分泌呈负相关;血肌酐、血尿素氮杓型组与非杓型组无明显差异。结论原发性高血压病患者昼夜节律与高血压性肾脏损伤密切相关。Objective To observe the impact Bp circadian rhythm changes on renal injury in patients with Primary Hypertension. Methods A total of 171 cases with mild - moderate hypertension were divided into arytenoid group and non - arytenoid group which were on significant differences in age and gender, according to the dec.line rate of night average pressure below average daytime pressure. Applied 24 h ambulatory blood pressure monitoring,24 hour urine mAIb and renal function biochemical measurements to comparing the influence of Bp ciradian rhythm to renal injure in two group patients. Results There was no distinct differenes in 24 h SBP and DBP or daytime average SBP and DBP （ P 〉 0.05 ） ; there was notable differences in nighttime average SBP and DBP （ P 〈 0.01 ）; there was notable differences in the rate of BP decrease in nighttime hetween two groups （ P 〈 0.01 ） , the rate of SBP decrease in blood pressure in arvtenoid group and nero - arvtenoid group were （ 13.29 ±4.21 ）% and （4.05 ± 3.64） % , the rate of DBP decrease in bhood pressure in arytenoid group and non - arytenoid group were （ 14.50 ± 3.56 ） % and（ 2.63 ±3.61 ） % respectively ; there was notable differences in 24 h urine mAlb （ P 〈 0. 0l ） , which in arytenooid group and non - arylenoid group were （87.97 ± 12.96） mg24 h and （ 110. 10 ± 27.21 ）mg/24 h ;the rate of decline in nighttime anti urinary protein secrefion was negative correlated; there was no distinct difference in serum Cr and BUN between arytenoid group and non - arytenoid group. Conclusion Bp circadian rhythm changes in patients with Primary Hypertension closely related hypertensive renal damage.

关 键 词：原发性高血压 血压昼夜节律 肾脏损伤 尿微量白蛋白 

分 类 号：R544.1[医药卫生—心血管疾病]