Cheng Li-Tao, Jiang Hong-Ying, Tang Li-Jun, Wang Tao
Division of Nephrology, First Hospital, Peking University, Beijing, China.
Blood Purif. 2006;24(5-6):499-507. doi: 10.1159/000096077. Epub 2006 Oct 2.
A seasonal variation in blood pressure (BP) has been observed in hemodialysis and renal transplant patients. However, this phenomenon in continuous ambulatory peritoneal dialysis (CAPD) patients, whose hemodynamics are different from hemodialysis patients, has not been reported before. In addition, the contribution of extracellular water (ECW) in the seasonal variation in BP is not clear.
All stable CAPD patients (n = 122) dialyzed in a single center from January 1, 2003 to December 12, 2004 were studied. Systolic blood pressure (SBP), diastolic blood pressure (DBP), weight and ECW (by bioimpedance analysis) were measured in every patient. Climatic data were obtained from the Beijing Weather Bureau. These data were pooled together and grouped according to the calendar month.
In general, an apparent seasonal variation in BP was observed in CAPD patients. BP began to decrease from spring and reached the lowest level in summer, then increased from autumn and reached its peak in winter. The seasonal variation in BP in male patients was similar to that in female patients, but in comparison to non-diabetic patients there was no apparent seasonal variation in the BP of diabetic patients. SBP and DBP negatively correlated with the average atmospheric temperature (r = -0.768, p < 0.001 and r = -0.764, p < 0.001, respectively). BP also negatively correlated with rainfall and humidity, but this correlation disappeared when temperature was controlled in partial correlation analysis. Weight and ECW fluctuated throughout the year but showed no seasonal variation.
On the whole there was an apparent seasonal variation in blood pressure in CAPD patients. As opposed to non-diabetic patients, there was no apparent seasonal variation in BP in diabetic patients. The seasonal variation in BP was influenced more by temperature than rainfall and humidity, and the change in ECW was not seasonal, suggesting that other mechanisms such as total peripheral resistance might play a more important role in this phenomenon.
血液透析和肾移植患者的血压存在季节性变化。然而，持续非卧床腹膜透析（CAPD）患者的血流动力学与血液透析患者不同，此前尚未有关于该现象的报道。此外，细胞外液（ECW）在血压季节性变化中的作用尚不清楚。
对2003年1月1日至2004年12月12日在单一中心进行透析的所有稳定CAPD患者（n = 122）进行研究。测量每位患者的收缩压（SBP）、舒张压（DBP）、体重和ECW（通过生物电阻抗分析）。气候数据来自北京市气象局。将这些数据汇总并按日历月份分组。
总体而言，CAPD患者的血压存在明显的季节性变化。血压从春季开始下降，夏季降至最低水平，然后从秋季开始上升，冬季达到峰值。男性患者的血压季节性变化与女性患者相似，但与非糖尿病患者相比，糖尿病患者的血压没有明显的季节性变化。SBP和DBP与平均气温呈负相关（r = -0.768，p < 0.001；r = -0.764，p < 0.001）。血压也与降雨量和湿度呈负相关，但在偏相关分析中控制温度后，这种相关性消失。体重和ECW全年波动，但无季节性变化。
总体而言，CAPD患者的血压存在明显的季节性变化。与非糖尿病患者不同，糖尿病患者的血压没有明显的季节性变化。血压的季节性变化受温度的影响大于降雨量和湿度，且ECW的变化不是季节性的，这表明其他机制如总外周阻力可能在这一现象中起更重要的作用。
