急性脑梗死合并肾损伤患者血压与肾功能的关系  

Relationship between blood pressure and renal function in patients with acute cerebral infarction complicated with renal injury

作　　者：李红艳[1] 秦历杰[1] 王龙安[1] Li Hongyan;Qin Lijie;Wang Longan(Department of Emergency,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院急诊科,郑州450003

出　　处：《中国实用医刊》2019年第20期17-20,共4页Chinese Journal of Practical Medicine

基　　金：河南省科技厅科技攻关项目(112102310234)。

摘　　要：目的探讨急性脑梗死合并肾损伤患者血压与肾功能的关系.方法抽取2016年5月至2018年9月河南省人民医院急诊内科急性脑梗死合并肾损伤患者326例,依据肾小球滤过率对肾损伤进行分期,其中CKD3期160例,CKD4期94例,CKD5期72例.326例患者均测量血压,按照传统的血压分类方法分为正常血压、单纯收缩期高血压、单纯舒张期高血压、双期高血压.结果血压总体控制率为44.9%,且随着CKD分期逐级降低.CKD3、CKD4、CKD5期单纯舒张期高血压发生率分别为5.2%、5.3%和1.0%,双期高血压CKD3、CKD4、CKD5期分别为15.1%、14.5%和15.9%,单纯收缩期高血压随着CKD分期逐级增高(CKD3、CKD4、CKD5期分别为28.2%、39.6%和45.9%).年龄和CKD分期是单纯收缩期高血压的独立危险因素,CKD4期和CKD5期患者发生收缩期高血压的风险分别是CKD3期的2.12倍和3.98倍.结论收缩期高血压发生率与急性脑梗死患者肾损伤程度呈正比,这也是导致肾损伤发展过程中心脑血管事件死亡率升高的一部分原因.Objective To investigate the relationship between blood pressure and renal function in patients with acute cerebral infarction complicated with renal injury.Methods A total of 326 patients with acute cerebral infarction and renal injury in Department of Emergency of Henan Provincial People's Hospital from May 2016 to September 2018 were selected.According to glomerular filtration rate,renal injury was staged,including 160 cases of CKD stage 3 and 94 cases of CKD stage 4 cases,72 cases of CKD5 stage.Blood pressure was measured in 326 patients.According to the traditional blood pressure classification method,they were divided into normal blood pressure,systolic hypertension,diastolic hypertension,and double-stage hypertension.Results The overall control rate of blood pressure was 44.9%,and it gradually decreased with the increase in CKD stage.The incidences of CKD3,CKD4,and CKD stage 5 diastolic hypertension were 5.2%,5.3%and 1.0%,respectively.The two stages of hypertension were CKD3,CKD4,and CKD5,which were 15.1%,14.5%,and 15.9%,respectively.The incidence of systolic hypertension increcreased with the CKD stage increasing,the incidence in CKD3,CKD4,CKD5 period were 28.2%,39.6%and 45.9%,respectively.Age and CKD stage were independent risk factors for isolated systolic hypertension.The risk of systolic hypertension in patients with CKD4 and CKD was 2.12 and 3.98 times,of that in patients in CKD3.Conclusions The incidence of systolic hypertension is directly proportional to the degree of renal injury in patients with acute cerebral infarction,which may partially contribute to increased cardiovascular mortality during the progress of conclusion kidney injury.

关 键 词：高血压 收缩期高血压 舒张期高血压 急性脑梗死 

分 类 号：R69[医药卫生—泌尿科学]