Nakamura I, Tsuzuki K, Ito S
Department of Pediatrics, Nakatsugawa Municipal Hospital, Gifu, Japan.
Acta Paediatr Jpn. 1995 Feb;37(1):52-7. doi: 10.1111/j.1442-200x.1995.tb03685.x.
Hypertension is a major problem of patients with chronic renal failure or renal transplant recipients. To clarify the characteristics of blood pressure, heart rate, and circadian rhythms of these patients we used an ambulatory blood pressure monitor (ABPM) for 24 h monitoring and analyzed the data by the cosinor method. In eight chronic renal failure patients without dialysis the midline estimating statistic of rhythm (MESOR) of diastolic blood pressure was higher than in controls, but the MESOR of systolic blood pressure was not. Of 11 patients on dialysis some had hypertension and some had hypotension. In 14 renal transplant recipients, especially those with chronic graft rejection, the MESOR of systolic and diastolic pressures were higher than controls, and the increase of blood pressure MESOR had a significant correlation with the elevation of serum creatinine levels. Circadian rhythms of blood pressure were frequently absent in the patients on dialysis, but circadian rhythms of heart rate were not. The use of an ABPM is a non-invasive method to monitor patients and allowed us to know changes of blood pressure and heart rate in the daytime as well as during the night. For the control of hypertension in chronic renal failure, monitoring with an ABPM seems to provide invaluable information.
高血压是慢性肾衰竭患者或肾移植受者的一个主要问题。为了阐明这些患者的血压、心率和昼夜节律特征，我们使用动态血压监测仪（ABPM）进行24小时监测，并通过余弦分析法对数据进行分析。在8例未接受透析的慢性肾衰竭患者中，舒张压的节律中线估计统计量（MESOR）高于对照组，但收缩压的MESOR则不然。在11例接受透析的患者中，有些患有高血压，有些患有低血压。在14例肾移植受者中，尤其是那些发生慢性移植排斥反应的患者，收缩压和舒张压的MESOR高于对照组，且血压MESOR的升高与血清肌酐水平的升高显著相关。接受透析的患者中血压昼夜节律常常消失，但心率的昼夜节律并非如此。使用ABPM是一种监测患者的非侵入性方法，使我们能够了解白天以及夜间血压和心率的变化。对于慢性肾衰竭患者高血压的控制，ABPM监测似乎能提供非常有价值的信息。
