老年高血压患者血压变异性对肾功能的影响

摘要

Objective To investigate the relationship between blood pressure variability (BPV)and renal injury in elderly patients with hypertension.Methods One hundred and twenty-three patients were divided into two groups (GFR≥90 ml/min group and GFR <90 ml/min group).Twenty-four hours ambulatory blood pressure monito-ring (ABPM)was performed in all patients.Results 1 .Patients in GFR≥90 ml/min group had lower day systolic BPV (SBPV)but higher day average blood pressure than patients in GFR <90 ml/min group;2.Correlation analysis showed positive correlation between GFR and age,day systolic BPV,and negative correlation between GFR and all day diastolic blood pressure (DBP),day DBP,mean BP,night DBP.Conclusion BPV,especially SBPV is closely relat-ed to renal dis-function.%目的：探讨老年人群中血压变异性与肾功能损害之间的关系。方法纳入123例老年高血压患者，计算入组患者的肾小球滤过率（GFR），以90 mL／min 为临界值将其分为肾功能正常组和肾功能异常组，监测患者的24 h 动态血压。结果（1）肾功能正常组白天的收缩压变异性明显小于肾功能异常组，但是白天的平均血压肾功能正常组却显著高于肾功能异常组；（2）年龄、白天收缩压的变异性与 GFR 呈负相关，而全天的舒张压，白天的舒张压、平均血压，夜间的舒张压与 GFR 呈正相关。结论血压变异性尤其是收缩压的变异性与肾功能不全独立相关。