血壓控制水平對(duì)慢性腎臟病患者腎功能的影響研究
發(fā)布時(shí)間:2019-05-11 15:10
【摘要】:目的探討血壓控制水平對(duì)慢性腎臟病(CKD)患者腎功能的影響。方法建立CKD患者隊(duì)列,納入患者均為2011年1月—2012年12月在首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院腎內(nèi)科門診就診的CKD患者,患者入組后,每月隨訪1次。最終,可將診室血壓控制在≤140/90 mm Hg水平(70%及以上時(shí)間)的患者共有148例,根據(jù)具體血壓控制情況,將該148例患者分為3組:A組(n=96),收縮壓120 mm Hg,舒張壓70 mm Hg;B組(n=28),120 mm Hg≤收縮壓≤130 mm Hg,70 mm Hg≤舒張壓≤80 mm Hg;C組(n=24),131 mm Hg≤收縮壓≤140 mm Hg,81 mm Hg≤舒張壓≤90 mm Hg。記錄并比較3組基線資料和實(shí)驗(yàn)室檢測(cè)指標(biāo),每月隨訪時(shí)記錄患者用藥情況,探討血壓控制水平對(duì)CKD患者腎功能的影響。結(jié)果 3組平均年齡和腎臟原發(fā)病比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);而性別、BMI、吸煙情況比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3組基線尿清蛋白/肌酐比值(ACR)和基線估算腎小球?yàn)V過率(e GFR)比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3組基線、末次隨訪時(shí)的限定日劑量(DDD)比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);3組DDD調(diào)整量比較,差異亦有統(tǒng)計(jì)學(xué)意義(P0.05);末次隨訪時(shí),B、C組DDD與基線比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);B、C組DDD調(diào)整量與A組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素Logistic回歸分析顯示,腎臟原發(fā)病、基線ACR、基線e GFR對(duì)CKD患者e GFR的影響有統(tǒng)計(jì)學(xué)意義(P0.05);而性別、年齡、血壓對(duì)其影響無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論在一定范圍內(nèi),血壓不是CKD患者腎功能的影響因素;而腎臟原發(fā)病、基線ACR、基線e GFR是其影響因素。對(duì)于臨床上無法將血壓控制在120/70 mm Hg以下的患者,可將其血壓水平控制在131~140/81~90 mm Hg以內(nèi)。
[Abstract]:Objective to investigate the effect of blood pressure control on renal function in patients with chronic kidney disease (CKD). Methods A cohort of CKD patients was established and included in the clinic of Department of Nephrology, Beijing Friendship Hospital affiliated to Capital Medical University from January 2011 to December 2012. The patients were followed up once a month after joining the group. Finally, there were 148 patients whose blood pressure could be controlled at 鈮,
本文編號(hào):2474599
[Abstract]:Objective to investigate the effect of blood pressure control on renal function in patients with chronic kidney disease (CKD). Methods A cohort of CKD patients was established and included in the clinic of Department of Nephrology, Beijing Friendship Hospital affiliated to Capital Medical University from January 2011 to December 2012. The patients were followed up once a month after joining the group. Finally, there were 148 patients whose blood pressure could be controlled at 鈮,
本文編號(hào):2474599
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