维持性血液透析患者血尿酸与血压昼夜节律、变异性的关系  

The relationship between uric acid and blood pressure circadian rhythm and blood pressure variability in maintenance hemodialysis patients

作　　者：田关源 傅君舟[1] 邱瑞华[1] 周姗姗[1] 董盖英 刘日光[1] 秦曙光[1] 李剑文[1] 

机构地区：[1]广州医科大学附属广州市第一人民医院肾内科,广东广州510180

出　　处：《热带医学杂志》2015年第8期1052-1056,共5页Journal of Tropical Medicine

摘　　要：目的探讨维持性血液透析(MHD)患者血尿酸(SUA)与血压昼夜节律、血压变异性(BPV)的关系。方法以广州市第一人民医院MHD患者为对象,以SUA中位数分为对照组和尿酸过高组,监测临床指标和动态血压,并分析SUA与动态血压关系。结果 217例MHD患者,76.04%为非杓型血压,对照组106例,尿酸过高组111例。与对照组相比,尿酸过高组的年龄、高血压患病率、非杓型血压比例、总胆固醇、血磷、全段甲状旁腺素较高。伴血压节律异常的尿酸过高组SUA与夜间血压下降率呈负相关。伴有血压节律异常的MHD患者SUA与全天收缩压标准差(24h SBPSD)和全天收缩压变异系数(24h SBPCV)呈正相关。Logistic回归分析提示MHD患者年龄、超敏C反应蛋白和SUA与非杓型血压正相关。结论 MHD患者以非杓型血压最为常见,SUA与非杓型血压显著正相关,伴血压节律异常的MHD患者SUA与收缩压变异性呈正相关。Objective To explore the relationship between serum uric acid（SUA）and blood pressure（BP） circadian rhythm and blood pressure variability（BPV） in maintenance of hemodialysis（MHD） patient. Methods The MHD patients in our hospital who met the criteria were recruited and divided into control group and high uric acid group by the median of SUA. Ambulatory blood pressure（ABP） monitoring was carried out and clinical parameters were measured regularly. Pearson correlation analysis and logistic regression analysis were used to examine the association between SUA and ABP parameters. Results 76.04% of 217 MHD patients had non-dipper BP profile. The control group included 106 patients, while there were 111 in the high uric acid group. As compared to control group, those in high uric acid group were older and had higher hypertension prevalence, ratio of non-dipper BP profile, cholesterol, serum phosphate and intact parathyroid hormone. The SUA of high uric acid group whose BP circadian rhythm was abnormal were negatively associated with the reduction percentage of nocturnal systolic BP and diastolic BP, respectively. The SUA of control group and high uric acid with abnormal BP circadian rhythm had positive correlation with 24-hours standard deviation of systolic blood pressure（24h SBPSD）, and also were positively correlated with 24-hours coefficient of variation of systolic blood pressure（24h SBPCV）.The logistic regression analysis revealed the non-dipper BP profiles in MHD patients were positively related with the age, high sensitivity C-reactive protein and SUA. Conclusion No-dipper profile was most common in MHD patients. The SUA was positively related with non-dipper profile and so with the systolic BPV in MHD patients with abnormal BP circadian rhythm.

关 键 词：维持性血液透析 动态血压 血压昼夜节律 血压变异性 血尿酸 

分 类 号：R457[医药卫生—治疗学]