摘要
目的了解诊室血压正常的慢性肾脏病(chronic kidney diseases,CKD)患者夜间血压状况,夜间高血压的发生率。方法选择诊室血压正常的CKD患者530例(无高血压228例,有高血压控制正常302例)。根据诊室血压水平,将患者分为正常血压组(n=190),正常高值组(n=340)。采用美国Spacelab无创便携式动态血压监测仪进行24 h血压监测。结果发现夜间动态血压均值升高210例,发生率39.62%(210/530),其中仅夜间出现高血压患者88例,83例患者昼夜血压均升高,39例夜间高血压伴24h动态血压均值升高。正常血压组,出现夜间高血压56例,发生率29.47%(56/190);正常高值组出现夜间高血压154例,发生率45.29%(154/340),两组比较差异具有统计学意义(P<0.001)。有高血压但控制正常的CKD患者与无高血压的CKD患者相比,夜间高血压发生率更高,为48% vs.28%,两者比较差异具有统计学意义(P<0.001)。结论血压控制正常的CKD患者夜间高血压发生率高,在CKD患者中应提倡动态血压监测,以发现夜间高血压及其它异常情况,为临床诊断、治疗提供可靠依据。
Objective To investigate the conditions of nocturnal blood pressure and the incidence of nocturnal hy- pertension in patients with chronic kidney disease （CKD） by office-based blood pressure. Methods A total of 530 CKD patients with normal blood pressure were selected （228 patients without hypertension, 302 patients under controlled hy- pertension）. According to the levels of office-based blood pressure, all patients were divided into normal blood pressure group （n = 190） and high-normal group （n = 340）. The 24-hour ambulatory blood pressure was monitored by portable non-invasive blood pressure monitoring （Spaeelah, USA）. Results The average of nocturnal ambulatory blood pressure of 210 patients increased, and the incidence was 39. 62% （210/530）. Among them, 88 patients were only nocturnal hyper- tension, and circadian blood pressure of 83 patients and nocturnal hypertension with 24-hour ambulatory mean blood pres- sure of 39 patients all increase＆ Fifty-six patients with nocturnal hypertension were found in the normal blood pressure group about 29. 47% （56/190）, and 154 patients with nocturnal hypertension appeared in the high-normal group about 45.29% （154/340）, there was significantly difference between two groups （P〈0. 001）. There was a higher incidence of nocturnal hypertension in CKD patients under controlled hypertension compared to CKD patients without hypertension （48% vs. 28%, P〈0. 001）. Conclusion The CKD patients under controlled hypertension have a higher incidence of noc- turnal hypertension. CKD patients should use the ambulatory blood pressure monitoring in case of nocturnal hypertension or other bnomalies. It also provides a reliable basis for clinical diagnosis and treatment.
出处
《华南国防医学杂志》
CAS
2017年第7期445-448,共4页
Military Medical Journal of South China
基金
上海市卫生局科研课题研究项目(2009247)
上海市静安区卫生系统医学学科建设特色专科项目(JWXK201205)
关键词
肾疾病
诊室血压
动态血压
夜间高血压
Chronic kidney disease
Office-based blood pressure
Ambulatory blood pressure
Nocturnal hyperten-sion
