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肝移植受者的24小时动态血压曲线

Twenty-four-hour ambulatory blood pressure profiles in liver transplant recipients.

作者信息

Del Compare Mónica E, D'Agostino Daniel, Ferraris Jorge R, Boldrini Gustavo, Waisman Gabriel, Krmar Rafael T

机构信息

Servicio de Gastroenterología y Transplante Hepático Pediátrico, Hospital Italiano, Buenos Aires, Argentina.

出版信息

Pediatr Transplant. 2004 Oct;8(5):496-501. doi: 10.1111/j.1399-3046.2004.00192.x.

Abstract

Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has proven to have better reproducibility than office blood pressure (BP) and is increasingly used for the study of hypertension in children and adolescents. The aim of our study was to assess 24-h BP profiles and to compare the results of office BP measurements with ABPM in stable liver transplant recipients transplanted before the age of 18 yr. ABPM was performed in 29 patients (nine males, 20 females), aged 3.9-24.8 yr (median 10.8 yr). The investigation was conducted 1.1-11.5 yr (median 5.1 yr) following transplantation. ABPM confirmed hypertension in one out of three office hypertensive patients. Seven patients (24%), whose office BP recordings were within the normotensive range, were reclassified as hypertensive. Non-dippers (n = 17), arbitrarily defined as patients with less than 10% nocturnal fall in BP, were similarly distributed among patients with ambulatory normotension and ambulatory hypertension (chi(2), p = 0.79). In addition, non-dippers showed a negative correlation between 24-h total urinary albumin excretion and both systolic and diastolic nocturnal decline in BP (Rho = -0.48, p < 0.05 and Rho = -0.86, p < 0.01, respectively). Our study found office BP readings to be poorly representative of 24-h BP profile. Larger studies are needed to confirm our observations as well as to determine whether routine BP measurements in the follow-up of paediatric liver transplant recipients should be based solely on office BP.

摘要

24小时动态血压监测(ABPM)已被证明比诊室血压(BP)具有更好的可重复性,并且越来越多地用于儿童和青少年高血压的研究。我们研究的目的是评估24小时血压情况,并比较18岁前接受稳定肝移植受者的诊室血压测量结果与动态血压监测结果。对29例患者(9例男性,20例女性)进行了动态血压监测,年龄为3.9 - 24.8岁(中位数10.8岁)。研究在移植后1.1 - 11.5年(中位数5.1年)进行。动态血压监测证实,三名诊室高血压患者中有一名患有高血压。7例患者(24%),其诊室血压记录在正常血压范围内,但被重新分类为高血压患者。非勺型血压者(n = 17),被随意定义为夜间血压下降小于10%的患者,在动态血压正常和动态血压高血压患者中分布相似(卡方检验,p = 0.79)。此外,非勺型血压者24小时尿白蛋白排泄总量与夜间收缩压和舒张压下降之间呈负相关(Rho分别为 - 0.48,p < 0.05和Rho = - 0.86,p < 0.01)。我们的研究发现诊室血压读数不能很好地代表24小时血压情况。需要更大规模的研究来证实我们的观察结果,并确定在儿科肝移植受者的随访中常规血压测量是否应仅基于诊室血压。

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