慢性肾脏病门诊患者单纯收缩期高血压与肾脏病分期的关系  

The relationship between the prevalence of isolated systolic hypertension and the stages of chronic kidney disease in chronic kidney disease outpatient clinic

作　　者：布海霞[1] 程李涛[2] 张爱华[2] 汪涛[2] 王悦[2] 范敏华[2] 

机构地区：[1]河南省新乡市中心医院肾内科 [2]北京大学第三医院肾内科,100191

出　　处：《中华肾脏病杂志》2015年第1期19-23,共5页Chinese Journal of Nephrology

基　　金：国家自然科学基金（30800522）;教育部新教师基金（200800011034）

摘　　要：目的 探讨慢性肾脏病（CKD）患者中单纯收缩期高血压（ISH）与CKD分期的关系.方法 选择CKD患者626例,按血压类型分为：正常血压、单纯舒张期高血压（IDH）、ISH和双期高血压（SDH）.观察4种血压亚型在CKD各期的百分比.结果 在CKD 1、2、3、4、5期,IDH患病率分别为9.1％、6.7％、2.9％、3.1％和4.1％;ISH患病率分别为0、9.2％、23.9％、28.6％和37.0％;SDH患病率分别为4.5％、8.4％、8.0％、17.3％和21.9％;血压控制率逐渐下降,分别为86.4％、75.6％、65.3％、51.0％和37.0％（P＜0.05）;多因素回归分析结果显示,年龄、糖尿病和CKD分期为发生ISH的独立危险因子.与CKD 1～2期比较,CKD 3、4、5期发生ISH的OR值分别为2.388、2.697和5.980.结论 CKD患者肾功能受损的的程度与ISH进展一致.Objective To investigate the relationship between the prevalence of isolated systolic hypertension （ISH） and the stages of chronic kidney disease （CKD） in chronic kidney disease outpatient clinic.Methods CKD patients of stages 1,2,3,4 and 5 were recruited （n=626）.Based on office systolic pressure （SBP） and diastolic pressure （DBP）,they were classified into four subtypes：normotension （〈 140/90 mmHg）,isolated diastolic hypertension （IDH,SBP 〈 140 mmHg and DBP ≥ 90 mmHg）,ISH （SBP≥ 140 mmHg and DBP 〈 90 mmHg） and systolic-diastolic hypertension （SDH,SBP≥140 mmHg and DBP≥90 mmHg）.Results The control rate of blood pressure was 86.4%,75.6%,65.3%,51.0% and 37.0% at CKD stage 1,2,3,4 and 5,respectively,which decreased with the advancement of CKD.There was a stepwise increase in the prevalence of ISH （0,9.2%,23.9%,28.6% and 37.0% at CKD stage 1,2,3,4 and 5,respectively） and SDH （4.5%,8.4%,8.0%,17.3%,21.9% at CKD stage 1,2,3,4 and 5,respectively）.Logistic regression analysis showed that age,diabetes and CKD stages were independent predictors of ISH.Compared with CKD stage 1-2,CKD stage 3,4 and 5 showed 2.388,2.697 and 5.980 folds risk in developing ISH.Conclusion The prevalence of ISH increases correspondingly with the advancement of stages of CKD,which may partially contribute to the increased cardiovascular mortality during the progress of CKD.

关 键 词：肾功能不全 慢性 高血压 单纯收缩期高血压 

分 类 号：R544.1[医药卫生—心血管疾病]