原发性高血压患者血压变异性与肾功能损害的相关研究

目的探讨原发性高血压患者血压变异性与肾功能损害之间的关系。方法对106例原发性高血压患者行24 h动态血压监测,采用简化肾脏病膳食改良试验(modification diet for renal disease,MDRD)方程估算肾小球滤过率(estimated glomerularfiltration rate,eGFR),并根据eGFR值将患者分为2组:每1.73 m2 eGFR<90 mL/min(A组)与每1.73m2 eGFR≥90 mL/min(B组)。结果 A组患者的24 h平均舒张压(24 h-diastolic blood pressure,24 h-DBP)、24 h收缩压变异性(24 h-systolic bloodpressure-standard deviation,24 h SBP-SD)均显著高于B组,将其带入回归方程并校正年龄、性别因素后,发现24 h-DBP(OR=0.913,P=0.019)、24 h SBP-SD(OR=0.803,P=0.049)仍与eGFR独立相关。结论除血压水平外,血压变异性与高血压患者的肾脏损伤程度密切相关。

Correlation between blood pressure variability and renal dysfunction in patients with primary hypertension

Objective To explore possible correlation between blood pressure variability and impaired renal function in hypertensive patients. Methods Twenty-four-hour ambulatory blood pressure monitoring(ABPM) was performed in 106 hypertensive patients. The estimated glomerular filtration rate(eGFR) was assessed using the abbreviated equation of the modification diet for renal disease(MDRD) study. Patients were divided into two groups: those with an eGFR less than 90 mL/min per 1.73 m²(group A) and those with an eGFR 90 mL/min per 1.73 m² or more( group B). Results Patients with low eGFR levels had higher 24 h-diastolic blood pressure(24 h-DBP) and higher 24 h-systolic blood pressure-standard deviation(24 h SBP-SD) in comparison to those with normal eGFR levels. The multivariable Logistic regression analysis showed that the negative relation between 24 h-DBP, 24 h SBP-SD and eGFR persisted(OR=0.913, P=0.019; OR=0.803, P=0.049, respectively) even after adjustment for age, male sex. Conclusion Besides blood pressure level, BPV level is also related to impaired renal function.