高血压病晨峰与早期肾功能损害相关性研究及降压疗效观察  

Correlation between morning blood pressure surge and renal damage at early stage and observation on antihypertensive effects

作　　者：余红[1] 岳瑞华[1] 张颖[1] 徐艺[1] 周希[1] 

机构地区：[1]重庆市急救医疗中心心内科,重庆400014

出　　处：《重庆医科大学学报》2013年第8期900-903,共4页Journal of Chongqing Medical University

摘　　要：目的:研究高血压病晨峰(morning blood pressure surge,MBPS)对早期肾脏功能损害的影响及降压治疗的作用。方法:通过24 h动态血压监测(ambulatory blood pressure monitoring ABPM),将252例高血压病患者分为MBPS组121例与非MBPS组131例,均行尿微量白蛋白(urine microalbumin,mALB)定量测定,治疗6个月后,再次行全部患者24 h ABPM检查和mALB定量测定。研究MBPS对早期肾脏功能损害的影响及消除MBPS后肾脏功能的变化。结果:治疗前MBPS组患者24 h、白昼、夜间平均收缩压均明显高于非MBPS组,二者差异具有统计学意义,治疗后两组患者血压均控制达标,各值间差异无显著性,MBPS组患者MBPS现象消失;MBPS组患者治疗前mALB值明显高于非MBPS组患者,二者分别为(72.0±13.6)mg/L,(43.0±14.6)mg/L,二者相比差异具有统计学意义,P<0.05,治疗后,2组患者mALB值均较治疗前下降,但MBPS组患者降低幅度更明显,其中非MBPS组mALB值治疗前后比较,P<0.05,而MBPS组患者mALB值治疗前后比较P<0.01。结论:MBPS现象加重肾脏功能的损害,降压治疗消除MBPS有利于保护肾脏功能。Objective ：To research effect of morning blood pressure surge（MBPS） on renal damage at early stage and antihypertensive treatment. Methods：By 24-hour ambulatory blood pressure monitoring （ABPM）, hypertensive patients were divided into MBPS group （n=121） and non-MBPS group（n=131）. All patients underwent urine microalbumin（mALB） quantitative determination. At 6 months after treatment,all patients underwent ABPM and mALB again. Effect of MBPS on renal damage at early stage and changes of renal function after the disappearance of MBPS were studied. Results：Before treatment, average systolic pressure at 24 h and at day and night of patients with MBPS was significantly higher than that in non＇MBPS group, with statistical differences. After treatment, blood pressure of both groups reached the standard and had no significant difference;MBPS was disappeared in MBPS group. Before treat- ment,mALB of patients with MBPS was significantly higher than that in non-MBPS group（72.0 ± 13.6） mg/L vs. （43.0± 14.6） mg/L, with statistical differences,P〈0.05. After treatment, mALB of both groups was decreased, more obviously in MBPS group,P〈0.05. There were statistical differences in mALB of MBPS group and non-MBPS group before and after the treatment,P〈0.05 and P〈0.01. Conclusions：MBPS aggravates renal function damage and eliminating MBPS will help protect renal function.

关 键 词：高血压晨峰 降压治疗 肾脏功能 

分 类 号：R544.1[医药卫生—心血管疾病]