原发性肾病综合征儿童24小时动态血压与肾素-血管紧张素-醛固酮水平的关系

目的应用24h动态血压监测(24hABPM)探讨原发性肾病综合征(PNS)儿童血压变化并探讨肾素-血管紧张素-醛固酮系统(RAAS)致24h动态血压(ABP)变化的机制。方法对114例PNS儿童进行24hABP和随机血压(CBP)监测,并检测血浆肾素(PRA)、血管紧张素II(AngII)和醛固酮(ALD)水平及与24hABP相关关系。结果 114例PNS儿童动态血压升高101例(88.6%),轻度、重度隐匿性高血压45例(39.5%),非杓型血压80例(70.2%)。收缩压(SBP)血压指数与负荷大于舒张压(DBP)血压指数与负荷。PNS儿童睡眠血压指数与负荷大于醒时血压指数与负荷。PNS儿童男性血压DBP指数与负荷均大于女性儿童DBP指数与负荷。PNS组卧位血PRA、AngII、ALD水平高于正常对照组,同时PNS儿童血压升高组卧位血AngII水平高于血压正常组。AngII与SBP、DBP指数和负荷均明显正相关。结论 PNS儿童发生高血压的比例较高,其中隐匿性高血压、非杓型血压占较大比例,SBP升高较DBP明显,睡眠血压升高更明显,男性DBP升高较女性更明显。PNS儿童RAAS水平升高可能主要通过AngII使血压上升。

Relationship of 24-hour ambulatory blood pressure and renin-angiotensin-aldosterone system in children with primary nephrotic syndrome

Objective To investigate the changes of blood pressure by 24-hour ambulatory blood pressure ( ABP) monitoring in children with primary nephrotic syndrome ( PNS) and explore the relationship of the changes in blood pressure with renin-angiotensin-aldosterone system ( RAAS) in these children. Methods ABP and casual blood pressure ( CBP) monitoring were performed in 114 children with PNS. Plasma levels of rennin activity ( PRA) ,angiotensin II ( AngII) and aldosterone ( ALD) were measured. The correlation of p...