血压评估参数与老年男性慢性肾脏病合并高血压病人肾功能下降的关系

doi:10.3969/j.issn.1003-9198.2021.04.011

摘要/Abstract

摘要： 目的研究不同血压评估参数与老年男性慢性肾脏病(CKD)3~4期合并高血压病人肾功能下降的关系。方法对2015年1月至2019年12月北京同仁医院老年医学科/干部医疗科112例CKD 3~4期合并高血压的老年男性病人的临床资料进行回顾性分析,记录病人连续2年临床检验数据及此2年间动态血压监测数据。以2年间eGFR减低>8 mL/(min·1.73m²)为肾功能进展依据,将病人分为肾功能稳定组和肾功能下降组,分析2组病人血压评估参数的差异。结果 2年前肾功能稳定组肾功能基线水平低于肾功能下降组(P<0.05),其余临床资料2组间差异无统计学意义(P>0.05);2组病人2年后肾功能及其他指标比较,差异均无统计学意义(P>0.05)。与肾功能稳定组相比,肾功能下降组2年前及2年后血压控制情况都较差,其白昼SBP平均值较高,白昼SBP不达标值占比亦较高。结论血压变异增大在老年男性CKD 3~4期病人中普遍存在,SBP控制不良可能是推动肾功能下降的主要原因之一。

关键词: 慢性肾脏病, 高血压, 血压变异, 老年, 肾功能进展

Abstract: Objective To explore the relationship between blood pressure parameters and renal dysfunction in the elderly male patients with CKD and hypertension. Methods The elderly male patients with CKD at stage 3-4 and hypertension in our hospital from January 2015 to December 2019 were selected. The clinical laboratory data and 24 h ambulatory blood pressure in two years were recorded in a row. The patients were divided into two groups according to eGFR decline [the level of eGFR decreased >8 mL/(min·1. 73m²)in two years]. The data of stable renal function group and progressive renal function group were statistically analyzed. Results The baseline level of renal function in the stable renal function group was lower than that in the progressive renal function group (P<0. 05), but there was no significant difference in other clinical data (P>0. 05); There was no significant difference in the observed parameters of renal function between the two groups two years later (P>0. 05). Compared with stable renal function group, the status of hypertension control in progressive renal function group was worse, especially in SBP(P<0. 05). Conclusions High blood pressure variability is common in the elderly male patients with CKD and hypertension. Poor control of SBP may be one of the main reasons for the renal progression.

Key words: chronic kidney disease, hypertension, blood pressure variability, aged, renal dysfunction

中图分类号:

R 586

陈莹, 刘琦. 血压评估参数与老年男性慢性肾脏病合并高血压病人肾功能下降的关系[J]. 实用老年医学, 2021, 35(4): 362-365.

CHEN Ying, LIU Qi. Relationship between blood pressure parameters and renal dysfunction in elderly male patients with chronic kidney disease[J]. Practical Geriatrics, 2021, 35(4): 362-365.

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