Pejcić I, Peco-Antić A, Parezanović V, Popović-Rolović M, Kostić M, Stojanov V, Jovanović I, Jovanović O, Kruscić D
University Children's Hospital, Belgrade.
Srp Arh Celok Lek. 1996;124 Suppl 1:94-6.
Recent evidence suggests that circadian blood pressure changes are common in patients with impaired renal function and has excellent correlation with end-organ damage. The aim of this paper was to: 1) evaluate if children with end-stage renal failure have altered circadian blood pressure rhythm; 2) assess whether pre- or postdialytic blood pressure is representative for the average interdialytic blood pressure; 3) assess whether pre- or postdialytic blood pressure is representative for the average interdialytic blood pressure; 3) determine influence of pre-, post and interdialytic blood pressure. Ambulatory blood pressure monitoring was performed in two groups of patients: group A-13 children with end-stage renal failure, aged 15.15 +/- 5.58 years, on chronic haemodialysis from 2 to 156 (mean 45.3) months, 4 of whom were hypertensive and 9 normotensive; group B-19 children with chronic hypertension (essential or renal hypertension) aged 15.28 +/- 2.27 years. 84.62% of children from group A and 31.58% from group B (p = 0.0037) had blunted circadian blood pressure rhythm (a nocturnal reduction of blood pressure is less than 10% of daytime values). Pre- and postdialytic systolic, diastolic and mean arterial blood pressure did not differ significantly and were in correlation with interdialytic blood pressure (r = 0.9; p < 0.01). Pre-, post- and interdialytic blood pressures correlated well with left ventricular mass index (r = 0.6; p < 0.05), but were not in correlation with the degree of hypervolemia (p < 0.05).
最近的证据表明,昼夜血压变化在肾功能受损患者中很常见,并且与靶器官损害具有良好的相关性。本文的目的是:1)评估终末期肾衰竭儿童的昼夜血压节律是否改变;2)评估透析前或透析后血压是否代表透析间期的平均血压;3)评估透析前或透析后血压是否代表透析间期的平均血压;3)确定透析前、透析后和透析间期血压的影响。对两组患者进行了动态血压监测:A组——13名终末期肾衰竭儿童,年龄15.15±5.58岁,接受慢性血液透析2至156(平均45.3)个月,其中4名高血压患者,9名血压正常者;B组——19名慢性高血压(原发性或肾性高血压)儿童,年龄15.28±2.27岁。A组84.62%的儿童和B组31.58%的儿童(p = 0.0037)昼夜血压节律减弱(夜间血压下降小于白天值的10%)。透析前和透析后的收缩压、舒张压和平均动脉血压无显著差异,且与透析间期血压相关(r = 0.9;p < 0.01)。透析前、透析后和透析间期血压与左心室质量指数相关性良好(r = 0.6;p < 0.05),但与血容量过多程度无关(p < 0.05)。