偶测血压正常的CKD患者的动态血压特点.DOC

偶测血压正常的慢性肾脏病患者的动态血压特点 李松杨1 上海静安区中心医院肾内科（1复旦大学附属华山医院静安分院，肾内科2老年科 邮编200040)顾波1 陈松2马骏1 武立群2 董蓓晔1 赵颖丹1 王汉卿1易扬1 宣怡1 摘要 目的 了解偶测血压正常的慢性肾脏病（CKD）患者的动态血压特点。方法 选择350例CKD1-5期，偶测血压正常的患者，男性136例，女性214例，年龄平均62.65±14.2岁。根据血压水平分为CKD血压正常组（146例）及血压高值组（204例），设对照组50例。肾脏病为原发和继发的肾小球疾病，肾小管疾病等。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，数据经软件自动分析。结果 动态血压均值升高147例，占42%，部分患者仅夜间血压升高；CKD血压高值组在24h血压，昼夜血压均值均显著高于CKD血压正常组及对照组，P0.01；隐性高血压（MHT）69例，MHT患病率为19.7%；血压模式异常（昼夜节律消失）199例（56.9%）；血压负荷增高204例（58.3%），以夜间血压负荷增高为主。结论 在偶测血压正常的CKD患者中，存在动态血压均值升高，隐性高血压，夜间高血压，血压负荷及血压模式异常的情况，应当引起重视。 关键词 慢性肾脏病；偶测血压；动态血压；血压负荷；血压模式；特点 The characteristics of Ambulatory blood pressure in CKD patients with normal casual blood pressure Li Song-yang 1 ,Gu Bo1 ,Chen song2, Ma Jun1 ,Wu li qung2, Dong Bei-ye 1,Zhao Yin-dan1 ,Wang Han-qing 1,Yi Yang1 ,Xuan Yi1 (1.Department of Nephrology; 2.Department of Lgeriatrics, Jing’an District Central Hospital of Shanghai(Huashan Hospital Fudan University Jing’an Branch) Shanghai 200040, China) Abstract: Objective Evaluate the characteristics of Ambulatory blood pressure in CKD patients with normal casual blood pressure. Methods Selected 350 cases of CKD1-5 grade patients who was with normal causal blood pressure, Among them, Male were 136 cases and female were 214 cases, the age were average 62.65 years old?4.2 years old. The patients were into CKD normal blood pressure groups(146 cases) and elevated normal blood pressure groups(204 cases), According to the levels of blood pressure, Fifty healthy person were as a control groups. Kidney disease were the primary and secondary glomerular diseases as well as renal tubular diseases. The 24 hours blood pressure was monitoring with United states of Spacelab ambulatory blood pressure instruments ,in these patients. The data was automatic analysis by software. Results There were 147 cases who had the average of ambulatory blood pressure increased , It was account for 42. %,Some of them had higher blood pressure only in the night; In elevated normal blood