早期糖尿病肾病伴高尿酸血症的血压变异性特点及相关分析  

Characteristics of blood pressure variability in early stage of diabetic nephropathy accompanied with hyperuricemia and correlation analysis

作　　者：杜渊[1] 黄德芳[1] 李春庆[1] 杜浩昌[1] 

机构地区：[1]南通大学第三附属医院肾内科,江苏无锡214041

出　　处：《中国现代医学杂志》2015年第36期49-53,共5页China Journal of Modern Medicine

摘　　要：目的分析比较伴有高尿酸血症的早期糖尿病肾病(HDN)和尿酸正常的早期糖尿病肾病(non-HDN)患者的血压变异性,探讨尿酸与早期糖尿病肾病血压变异性的相关性。方法选择60例符合入选标准的HDN患者,观察其24 h动态血压和血压变异性特点,并与70例基线特征相似的non-HDN患者的血压变异性结果相比较;分别将两组的尿酸值和相应的血压变异性指标进行相关分析。结果 1HDN组的夜间平均收缩压(n SBP)高于non-HDN组;2血压变异性指标:HDN组的夜间收缩压标准差(n SBP-SD)、夜间舒张压标准差(n DBP-SD)、24 h收缩压标准差(24 h SBP-SD)明显大于non-HDN组,(P<0.05);3HDN组的夜间血压下降率(NBPD)为(6.03±5.16)%,低于non-HDN组的(7.95±4.42)%,(P<0.05);4HDN组非杓型血压比例为80%,高于non-HDN组的61.4%,(P<0.05);5HDN组尿酸与n SBP-SD(R=0.376,P<0.01)、24 h SBP-SD(R=0.327,P<0.05)均有显著正相关,与N BPD呈负相关(R=-0.344,P<0.01);non-HDN组尿酸与血压变异性各指标无相关性。结论伴有高尿酸血症的早期DN患者血压变异性增高,生理性昼夜血压节律减少,尿酸与收缩压变异性呈正相关;高尿酸血症可能是早期DN血压变异性增高的危险因素。【Objective】 To compare the differences in blood pressure variability（BPV） between the patients with early-stage of diabetic nephropathies accompanied with hyperuricemia（HDN） and those without hyperuricemia（non-HDN） and to discuss the relationship of uric acid and blood pressure variability. 【Methods】 In the study 60 patients were enrolled in HDN group and 70 patients in non-HDN group, who were comparable at base line. The parameters of blood pressure and circadian rhythm were measured by ABPM. The differences in 24-h BPV were observed between the two groups and the correlation of uric acid and blood pressure vari ability（BPV） was analyzed in each group. 【Results】 1 The average nighttime systolic blood pressure（n SBP） in the HDN group was higher than that in the non-DN group. 2 In the HDN group, such features of BPV as n SBP-SD, n DBP-SD and 24-h SBP-SD were significantly higher than those in the non-HDN group（P 0.05）. 3 The rate of nighttime blood pressure decline（NBPD） in the HDN group dropped more significantly than that in the non-HDN group [（6.03 ± 5.16）% vs（7.95 ± 4.42）%, P 0.05]. 4 The prevalence of nondipping rhythm was higher in the HDN group than that in the non-DN group（80% vs 61.4%, P 0.05）. 5In the HDN group, the uric acid level was positively correlated with n SBP-SD（r = 0.376, P 0.01）, 24-h SBP-SD（r = 0.327, P 0.05）, but was negatively correlated with NBPD（r =-0.344, P 0.01）. Such correlations were not observed in the non-HDN group. 【Conclusions】 Blood pressure variability and the prevalence of abnormal circadian BP rhythm in early-stage of HDN patients are higher than those in non-HDN patients.The uric acid level is positively correlated with systolic blood pressure variability in HDN. Hyperuricemia may be a risk factor for increased blood pressure variability in early stage of diabetic nephropathy.

关 键 词：糖尿病肾病 血压变异性 高尿酸血症 24 h动态血压 

分 类 号：R589.7[医药卫生—内分泌]