动态血压监测在评价慢性肾脏病合并高血压患者血压达标中的价值  

Value of Ambulatory Blood Pressure Monitoring in the Evaluation of Blood Pressure in Patients with Chronic Kidney Disease Complicated with Hypertension

作　　者：刘星[1] 马文[1] 陆瑶[1] 黄志军[1] 袁洪[1] 

机构地区：[1]中南大学湘雅三医院,湖南省长沙市410013

出　　处：《中国动脉硬化杂志》2014年第1期32-36,共5页Chinese Journal of Arteriosclerosis

基　　金：十二五国家科技支撑计划(2012BA137B05);国家自然科学基金(81273594;81102512);重大基础研究前期研究专项(2011CB512001)

摘　　要：目的比较动态血压及诊室血压评价慢性肾脏病（CKD）合并高血压患者血压达标率的差异。方法选取2012年5月～2013年2月在中南大学湘雅三医院就诊的225例慢性肾脏病合并高血压患者。收集并分析研究对象的人口学、实验室检查及血压资料。结果（1）诊室血压监测和动态血压监测均随着肾功能恶化，血压达标率下降。其中诊室收缩压达标率CKD5期较CKDl—2期下降有统计学意义（18．3％比36．6％，P〈0．05），动态血压监测平均血压、日间收缩压、夜间血压达标率CKD5期较CKDl～2期下降均有统计学意义（P〈0．05）。（2）CKDl～2期患者动态血压高血压检出率高于诊室血压高血压检出率（79．6％比61．3％，P=0．038），而CKD5期患者动态血压高血压检出率低于诊室血压高血压检出率（83．5％比93．0％，P=0．029）。结论（1）随着肾功能恶化，CKD合并高血压患者血压达标率逐渐降低；（2）仅使用诊室血压评价CKD患者血压是否达标及昼夜血压达标情况存在不当，推荐CKD合并高血压患者使用动态血压监测。Aim To compare the difference in blood pressure control rate between ambulatory blood pressure （ABP） and office blood pressure （OBP） in chronic kidney disease （CKD） patients. Methods We enrolled 225 CKD patients complicated with hypertension in our hospital during 2012. 5 - 2013.2. The general and blood pressure information about these patients were recorded. Results （ 1 ） Compared with CKD 1 - 2 patients, the decline of blood pressure con- trol rate of office systolic blood pressure, 24 h average blood pressure, especially the night time blood pressure in CKD 5 patients were significantly different （ P 〈 0. 05 ）. （2） The blood pressure detection rate evaluated by OBP and ABP were different. In CKD 1 - 2 patients, ambulatory blood pressure detection rate were lower than office blood pressure control rate （79. 6% vs 61.3%, P = 0. 038）, however, in CKD 5 patients, the result was on the contrary（83.5% vs 93.0%, P = 0. 029）. Conclusions （ 1 ） With the deterioration of renal function, the blood pressure control rate decreases. （2） There are differences between the blood pressure control rate evaluated by two blood pressure measurements in CKD patients of different clinical stage, so it is necessary for CKD patients to take ambulatory blood pressure measurements.

关 键 词：慢性肾脏病 高血压 动态血压监测 诊室血压 

分 类 号：R5[医药卫生—内科学]