2019 年第 2 期 第 14 卷

H型高血压患者的血压变异性和肾损伤情况及二者的相关性

Relation between blood pressure variability and renal injury in patients with H-type hypertension

作者：吴轶王彤陈礼平李瑞黄德慧柯淑兰

英文作者：

单位：310000杭州,浙江中医药大学第三临床医学院中西医结合临床（心血管方向）在校硕士研究生（吴轶、王彤、李瑞）；323000浙江省丽水市中医院心内科（陈礼平、柯淑兰），肾内科（黄德慧）

英文单位：

关键词：H型高血压；血压变异性；肾损伤

英文关键词：

• 摘要：

• 【摘要】目的    探究H型高血压患者的血压变异性和肾损伤情况及二者的相关性。方法    选取2017年1月至2018年5月就诊于浙江省丽水市中医院的高血压患者127例。根据血同型半胱氨酸（Hcy）水平将患者分为观察组(Hcy≥10 mmol/L，86例)和对照组(Hcy<10 mmol/L，41例)。检测2组患者白天、夜间和24 h的收缩压及舒张压变异系数、尿微量白蛋白、肾小球滤过率和血肌酐，并做相关性分析。结果    观察组患者白天、夜间及24 h收缩压变异系数和24 h舒张压变异系数均明显大于对照组［(14.1±3.3)比(11.6±3.0)、(10.6±2.8)比(8.3±2.8)、(12.5±4.4)比(9.6±3.5)、(10.3±2.9)比(8.1±3.1)］（均P<0.05）。 观察组尿微量蛋白水平高于对照组，肾小球滤过率低于对照组［(126±66)mg/gCr比(79±37)mg/gCr、(93±15)ml/(min·1.73 m2)比(105±14)ml/(min·1.73 m2)］，差异均有统计学意义(均P<0.01)；2组血肌酐水平差异无统计学意义(P>0.05)。24 h收缩压变异系数和24 h舒张压变异系数增高是尿微量白蛋白和肾小球滤过率的危险因素(均P<0.05)；而血肌酐水平仅与24 h收缩压变异系数增高有关(P<0.05)。结论    H型高血压患血压变异性明显增加且肾损伤更加严重；血压变异性增高是肾损伤的危险因素。

• 【Abstract】Objective    To explore the relation between blood pressure variability and renal injury in patients with H-type hypertension. Methods    A total of 127 patients with hypertension were enrolled from January 2017 to May 2018 in Lishui Hospital of Traditional Chinese Medicine. The patients were divided into observation group［Homocysteine(Hcy)≥10 mmol/L, 86 cases］ and control group(Hcy<10 mmol/L, 41 cases). Systolic and diastolic blood pressure variation coefficients during the day, night and 24 h, urinary albumin, glomerular filtration rate and serum creatinine were measured. Results    Systolic blood pressure variation coefficients during the day, night, 24 h and 24 h diastolic blood pressure variation coefficient in observation group were significantly higher than those in control group［(14.1±3.3) vs (11.6±3.0), (10.6±2.8) vs (8.3±2.8), (12.5±4.4) vs (9.6±3.5), (10.3±2.9) vs (8.1±3.1)］（P<0.05）. Urinary albumin level in observation group was significantly higher and glomerular filtration rate was significantly lower than those in control group［(126±66)mg/gCr vs (79±37)mg/gCr, (93±15)ml/(min·1.73 m2) vs (105±14)ml/(min·1.73 m2)］(P<0.01). There was no significant difference of serum creatinine between groups(P>0.05). The 24 h systolic and diastolic blood pressure variation coefficients were risk factors of urinary albumin and glomerular filtration rate(P<0.05). Creatinine was only associated with the 24 h systolic blood pressure variation coefficient(P<0.05). Conclusion    Blood pressure variability is a risk factor of renal injury in patients with H-type hypertension.