摘要
目的:探讨儿童原发性肾病综合征(primary nephrotic syndrome,PNS)患者的动态血压变化特点。方法:回顾性分析上海儿童医学中心106例PNS患儿的24 h动态血压报告。结果:PNS患儿高血压发生率为60.4%(64/106),其中62例(58.5%)于夜间发生高血压,17例(16.0%)于日间发生高血压,PNS患儿夜间的高血压发生率高于日间(P<0.05)。夜间收缩压(systolic blood pressure,SBP)和舒张压(diastolic blood pressure,DBP)负荷均大于日间负荷[夜间SBP(52.32±36.87)%比日间SBP(19.41±19.70)%,夜间DBP(39.22±34.69)%比日间DBP(18.42±21.66)%, P<0.05]。106例患儿中,92例(86.8%)存在SBP和(或)DBP动态血压昼夜节律异常,且均以非杓型为主(68.9%),而SBP节律比DBP节律更易出现异常(79.2%比65.1%,P=0.022),SBP的夜间下降比值与DBP间比较差异具有统计学意义[SBP(3.52%±6.97%)比DBP(7.78%±9.18%),P<0.001]。白大褂高血压发生率为12.3%,隐匿性高血压发生率为14.2%。结论:PNS患儿易发生夜间高血压和昼夜血压节律异常,尤其SBP异常更多见。应重视PNS患儿的动态血压监测,尤其是夜间血压数值和血压节律,以指导临床治疗。
Objective: To explore the characteristics of the changes of ambulatory blood pressure(ABP) in the children with primary nephrotic syndrome(PNS). Methods: A total of 106 PNS children′s reports of 24-hour ambulatory blood pressure in Shanghai Children′s Medical Center were analyzed retrospectively. Results: The incidence of hypertension in PNS children was 60.4%(64/106), and 58.5%(62/106) children had nighttime hypertension, and 16.0%(17/106) children had daytime hypertension. The incidence of hypertension at night was higher than that in daytime(P<0.05). The loads of systolic blood pressure(SBP) and diastolic blood pressure(DBP) at night were higher than those at the daytime(SBP52.32% ±36.87% vs 19.41% ±19.70%, DBP 39.22% ±34.69% vs 18.42% ±21.66%, P <0.05). Among 106 children, 92(86.8%) had abnormal circadian rhythms in SBP and/or DBP ambulatory blood pressure, and most of them were non-dippers(68.9%). SBP rhythm was more likely to be abnormal than DBP rhythm(79.2% vs 65.1%, P=0.022). There was a statistical difference in the rate of blood pressure decline between SBP and DBP at night [SBP(3.52% ±6.97%) vs DBP(7.78%±9.18%), P<0.001]. The incidence of white-coat hypertension was 12.3%, and the incidence of masked hypertension was 14.2%. Conclusions: PNS children are prone to nocturnal hypertension and abnormal circadian rhythm, especially SBP. 24 h ambulatory blood pressure is conducive to collecting blood pressure change information and to guide the rational use of antihypertensive drugs for PNS children.
作者
沈小钰
沙莎
殷蕾
周纬
骆凝馨
王雪峰
SHEN Xiaoyu;SHA Sha;YIN Lei;ZHOU Wei;LUO Ningxin;WANG Xuefeng(Department of Nephrology,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;International Medical Department,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;Neonatal Intensive Care Unit,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;Department of Pediatrics,Afiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning Shenyang 110032,China)
出处
《诊断学理论与实践》
2022年第5期613-618,共6页
Journal of Diagnostics Concepts & Practice
基金
上海市综合医院中西医结合专项项目(ZHYY-ZXYJHZX-202027)
上海交通大学医学院科技基金项目(Jyh1912)
上海儿童医学中心院级科研课题(HL-SCMC2018-3)。
关键词
动态血压
儿童
原发性肾病综合征
Ambulatory blood pressure
Pediatric
Primary nephrotic syndrome
