原发性高血压患者动态血压监测指标与估算的肾小球滤过率异常的关系  

Association of ambulatory blood pressure monitoring indicators and abnormal eGFR in patients with essential hypertension

作　　者：狄欣欣 高敏[1] 李京秀 王慕秋 仇鑫 王静[1] 丁蓓蓓 Di Xinxin;Gao Min;Li Jingxiu;Wang Muqiu;Qiu Xin;Wang Jing;Ding Beibei(Department of Electrocardiogram,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)心电科,合肥230001

出　　处：《中国临床保健杂志》2022年第6期811-814,共4页Chinese Journal of Clinical Healthcare

基　　金：安徽省卫生健康科研项目(AHWJ2022a008)。

摘　　要：目的探讨原发性高血压患者24 h动态血压监测指标与估算的肾小球滤过率(eGFR)异常的关系。方法选择中国科学技术大学附属第一医院(安徽省立医院)2018年1月至2021年6月收治的272例原发性高血压患者,根据eGFR水平分为eGFR正常组229例(eGFR≥90 mL·min^(-1)·1.73 m^(-2))和eGFR异常组43例(eGFR<90 mL·min^(-1)·1.73 m^(-2)),比较2组患者一般临床资料、血脂、24 h动态血压监测指标及肾功能的差异,并分析24 h动态血压监测指标与eGFR的关系。结果原发性高血压患者的eGFR异常与其收缩压(r=-0.142,P=0.019)、夜间平均收缩压(r=-0.146,P=0.016)、24 h平均收缩压(r=-0.221,P<0.001)、24 h脉压(r=-0.273,P<0.001)、日间脉压(r=-0.167,P=0.006)及夜间脉压(r=-0.195,P=0.001)显著相关;在调整年龄、收缩压、尿酸、尿素后,发现原发性高血压患者的24 h脉压(OR=1.26,95%CI:1.02~1.56,P=0.032)、日间脉压(OR=1.38,95%CI:1.12~1.70,P=0.003)与eGFR异常显著相关。结论24 h动态血压监测指标与eGFR异常相关联,对原发性高血压肾功能损伤的早期诊断具有重要价值。Objective To explore the association between 24 h ambulatory blood pressure monitoring indicators and abnormal estimated glomerular filtration rate(eGFR)in patients with essential hypertension.Methods Two hundred and seventy two patients with essential hypertension between January 2018 and June 2021 were analyzed.Among the 272 patients with essential hypertension,there were 229 patients with eGFR≥90 mL·min^(-1)·1.73 m^(-2)and 43 patients with eGFR<90 mL·min^(-1)·1.73 m^(-2).We performed observational research on the clinical characteristics,lipid level,the therapy of antihypertensive drugs,24 h ambulatory blood pressure monitoring indicator,and renal function.We analyzed the relationship between 24 h ambulatory blood pressure monitoring indicators and abnormal eGFR.Results Statistical analysis of the data revealed that there was a significant relationship between systolic blood pressure(r=-0.142,P=0.019),the night average systolic blood pressure(r=-0.146,P=0.016),24 h average systolic blood pressure(r=-0.221,P<0.001),24 h pulse pressure(r=-0.273,P<0.001),the day pulse pressure(r=-0.167,P=0.006),the night pulse pressure(r=-0.195,P=0.001)and the abnormal eGFR in patients with essential hypertension.After adjusting for age,systolic blood pressure,uric acid,blood urea nitrogen,24 h pulse pressure(OR:1.26,95%CI:1.02-1.56,P=0.032),day pulse pressure(OR:1.38,95%CI:1.12-1.70,P=0.003)were significantly associated with abnormal eGFR.Conclusions The 24 h ambulatory blood pressure monitoring indicators are associated with abnormal eGFR,which is of great value for the early diagnosis of primary hypertensive renal injury.

关 键 词：原发性高血压 肾功能不全 诊断技术和方法 血压监测 肾小球滤过率 

分 类 号：R544.11[医药卫生—心血管疾病]