慢性肾脏疾病患者血压变异性与血脂异常的关系

目的探讨慢性肾脏疾病（chronickidneydisease，CKD）1～4期患者血脂代谢异常与血压变异性的相关性。方法入选142例CKD1-4期的患者，将不伴有高脂血症的患者47例设为A组，其中男28例，女19例；伴有高脂血症的患者95例设为B组，其中男56例，女39例。记录2组饮酒史、吸烟史、病程、年龄、性别、身高、体质量、诊所血压，并计算体质量指数。测量空腹时血清总胆固醇（totalcholesterol，TC）、三酰甘油（triglyceride）、低密度脂蛋白胆固醇（10wdensitylipopro—teincholesterol，U）L厂C）、高密度脂蛋白胆固醇（high-densitylipoproteincholesterol，HDL-C）、肌酐、尿酸，对入选的患者进行24h动态血压监测（ambulatorybloodpressure，ABPM）。收集血压参数，将2组血压标准差及变异系数进行对比分析，并将B组的血压变异系数与血脂值进行相关性检验与回归分析，了解血脂异常与CKD患者血压变异性的相关性。结果与A组比较，B组的24h收缩压标准差变异系数和白昼收缩压标准差变异系数增大，差异有统计学意义（P〈0．05），B组24h收缩压标准差变异系数与TC值呈正相关（r=0．21，P=0．03），但未能建立回归方程；白昼收缩压标准差变异系数与TC值呈正相关（r=0．19，P=0．04），但未能建立回归方程；夜间收缩压标准差变异系数与TC值呈正相关（r=0．22，P=0．02），但未能建立回归方程。结论CKD合并血脂异常较不伴有血脂异常者血压变异性增大，且收缩压血压变异性与TC值呈正相关，提示CKD患者血压变异性与血脂异常之间存在密切的关系，二者联合干预治疗对于减少CKD患者心血管疾病的发生、改善CKD发展和预后具有重要的意义。

Correlation between blood pressure variability and abnormal lipid metabolism in patients with chronic kidney disease

Objective To explore the correlation between blood pressure variability（BPV） and ab- nomral lipid metabolism in patients with state 1 ~ 4 chronic kidney disease （CKD）stage 1 to 4. Methods 142 patients with CKD of stage 1 to 4 were divided into simple CKD group （group A, n = 47, including 28 males and 19 femals）, and CKD ＋ abnormal lipid metabolism group （group B, n = 95, inclu- ding 56 males and 39 femals）. Drinking history, smoking history, the disease cause, age, gender, height, weight, clinic blood pressure, and the body mass index were recorded. Fasting plasma glucose, total cho- lesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, creatinine, u- ric acid, and 24-h ambulatory blood pressure were measured. Blood pressure standard deviation and coeffi- cient of variation were compared and analyzed between two groups. The BPV and blood lipids in group B were subjected to the coefficient value correlation test and regression analysis to understand the correla- tion between abnormal blood lipid and BPV in patients with CKD. Results As compared with group A, 24-h SBPCV and dSBPCV were significantly increased （P〈0. 05）. In group B, 24-h SBPCV was posi-tively correlated with total cholesterol levels （r= 0.21, P= 0. 21 ） but failed to establish the regression e- quation; dSBPCV was positively correlated with total cholesterol levels （r = 0. 19, P = 0. 19）, but failed to establish the regression equation; nSBPCV was positively correlated with total cholesterol levels （r = 0. 22, P = 0. 22）, but failed to establish the regression equation. Conclusions The BPV in CKD patients with abnormal lipid metabolism is increased as compared with that in patients with simple CKD, and SB- PV has a positive correlation with total cholesterol levels. It reminders that in patients with CKD, BPV has a close relationship with dyslipidemia. The combined intervention therapy for CKD and dyslipidemia could significantly reduce the occurrence of cardiovascular