摘要
目的:探讨原发性高血压患者血压昼夜节律与肾小球滤过率(GFR)的关系。方法:对242例原发性高血压患者测定血清肌酐,以Cockroff-Gault公式计算GFR估测值(eGFR),根据eGFR≥90ml/(min.1.72 m2)、60～89 ml/(min.1.72 m2)、40～59 ml/(min.1.72 m2)、<40 ml/(min.1.72 m2)分为A组60例、B组71例、C组62例、D组49例,并行24 h动态血压监测,测定空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇,计算体重指数。结果:A组、B组、C组和D组随着eGFR的下降,夜间收缩压、24 h脉压、昼间脉压、夜间脉压、收缩压晨峰逐渐升高;舒张压波动幅度逐渐降低,差异均有统计学意义(P均<0.05)。夜间收缩压下降率、夜间脉压下降率明显降低,夜间舒张压下降率明显升高,差异均有统计学意义(P均<0.05)。Pearson相关分析显示,病程、夜间收缩压、收缩压晨峰、24 h脉压、夜间脉压及夜间舒张压下降率与eGFR呈负相关,夜间舒张压、舒张压波动幅度、夜间收缩压下降率、夜间脉压下降率与eGFR呈正相关(P<0.05)。结论:血压昼夜节律和波动幅度的异常与eGFR密切相关。
Objective ：To study the relationship between blood pressure circadian rhythm and glomerular filtration rate（GRF） in patients with primary hypertension. Methods ： A total of 242 patients with primary hypertension were enrolled. The estimated GFR （eGFR） was calculated with Cockcroft-Gault equation and the patients were divided into 4 groups. Group A, n = 60, eGFR ≥90 ml/（ min · 1.72 m2）, group B, n = 71, eGFR 60 - 89 ml/（ min · 1.72 m2 ）, group C, n = 62, eGFR 40 - 59 ml/（ min · 1.72 m2 ） and group D, n = 49, eGFR 〈 40 ml/（ min ·1.72 m2 ）. 24 h blood pressure was dynamically monitored, fasting plasma glucose, TC, TG, LDL-C, HDL-C and body mass index were measured in all patents. Results：With decreased eGFR,from groups A to D, the nocturnal systolic blood pressure,24 h, diurnal and nocturnal pulse pressure, morning systolic pressure peak increased ; while the diastolic pressure fluctuation decreased accordingly P〈0. 05 respectively. From Groups A to D, there were obviously less decreasing rates of nocturnal systolic pressure, pulse pressure, and more decreasing rate of nocturnal diastolic pressure accordingly, P 〈 0. 05 respectively. Pearson correlation analysis showed that the eGFR was negatively related to the course of disease,nocturnal and morning systolic pressure,24 h and nocturnal pulse pressure and the decreased rate of nocturnal diastolic pressure; eGFR was positively related to nocturnal diastolic pressure, diastolic pressure fluctuation and the decreased rates of nocturnal systolic and pulse pressure,P〈0.05 respectively. Conclusion：Circadian rhythm and fluctuation of blood pressure are closely related to eGFR in patients with primary hypertension.
出处
《中国循环杂志》
CSCD
北大核心
2012年第6期446-449,共4页
Chinese Circulation Journal
关键词
原发性高血压
昼夜节律
肾小球滤过率
Primary hypertension
Circadian
Glomerular filtration rate
作者简介
作者简介：胡小李，主治医师，学士，主要从事心血管内科工作，Email：184737234@qq．com
通讯作者：周斌全Email：denzhou@hotmail．com
