2型糖尿病合并不同分期慢性肾脏疾病患者的血压特点  

Characteristics of blood pressure in type 2 diabetic patients with different degree of chronic kidney disease

作　　者：韩菲[1] 杨立成[2] 孙红喜[1] 杨菊红[1] 常宝成[1] 

机构地区：[1]卫生部激素与发育重点实验室,天津医科大学代谢病医院糖尿病肾病科,300070 [2]天津医科大学,300070

出　　处：《国际内分泌代谢杂志》2015年第3期149-152,共4页International Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金资助项目（81173428,81373864）

摘　　要：目的 观察2型糖尿病合并不同分期慢性肾脏疾病（CKD）患者的血压特点.方法 将2型糖尿病合并CKD患者共409例,分为CKD1期组（127例）、CKD2期组（121例）、CKD3期组（81例）、CKD4期组（36例）、CKD5期组（44例）,统计各组高血压发生率,比较各组血压水平、节律特点.结果 随CKD进展,2型糖尿病合并CKD患者高血压发生率逐渐增加（x2=28.363,P＜0.05）,单纯收缩期高血压比例逐渐升高（x2=15.324,P＜0.05）,脉压水平逐渐升高（F=16.229,P＜0.05）;血压节律方面,随CKD进展,夜间血压下降百分率逐渐降低（F=6.753,5.105,P均＜0.05）,非杓型血压所占比例逐渐上升（x2=26.980,P＜0.05）.结论 2型糖尿病患者合并CKD分期不同,血压异常改变特点不同,整体血压异常特点为收缩压升高为主,脉压增大,同时伴血压节律异常.Objective To investigate the characteristics of blood pressure in type 2 diabetic patients with different degree of chronic kidney disease（CKD）.Methods Four hundred and nine patients of type 2 diabetes with CKD were divided into 5 groups：stage 1 group（n =127）,stage 2 group（n =121）,stage 3 group （n=81）,stage 4 group （n=36） and stage 5 group （n=44）.The incidence of hypertension,variability of blood pressure and circadian rhythm were evaluated.Results In type 2 diabetic patients with CKD,the incidence of hypertension,proportion of isolated systolic hypertension and level of pulse pressure increased significantly with the progression of CKD （x2=28.363,15.324,F =16.229,all P 〈 0.05）.And with the progression of CKD,the declining percentage of nocturnal blood pressure decreased （F =6.753,5.105,all P〈 0.05）,while the percentage of non-dippers increased（x2=26.980,P 〈0.05）.Conclusion The abnormality of blood pressure in type 2 diabetes is diverse at different stage of CKD,however increased systolic blood pressure and pulse pressure and abnormal circadian rhythm are common characters.

关 键 词：糖尿病 慢性肾脏疾病 高血压 昼夜节律 

分 类 号：R544.1[医药卫生—心血管疾病]