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【文摘发布】肾移植一年后日间血压的改变： 与
*Department of Medicine, Division of Nephrology and Hypertension, Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, and Department of Surgery, Division of Transplantation Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.
Loss of circadian BP change has been linked to target organ damage and accelerated kidney function loss in hypertensive patients with and without chronic kidney disease. Ambulatory BP-derived data from 119 consecutive kidney transplant recipients who presented for the first annual evaluation were examined in relation to allograft function, histology, and ultrasound findings. A total of 101 (85%) patients were receiving antihypertensive medications (median 2), and 85 (71%) achieved target awake average systolic BP (SBP) of <135 mmHg. A day-night change in SBP by 10% or more (dippers) was detected in 29 (24%). Dipping status was associated with younger recipient age, lack of diabetes, low chronic vascular score, and low resistive index. Nondippers and reverse dippers had lower GFR compared with dippers (P = 0.04). For every 10% nocturnal drop in SBP, GFR increased by 4.6 ml/min per 1.73 m(2) (R = 0.3, P = 0.003). Nondippers and reverse dippers were equally common in recipients with normal histology and in those with pathologic findings on surveillance biopsy. On multivariate analysis, percentage of nocturnal fall in SBP and elevated resistive index independently correlated with GFR. This study indicates that lack of nocturnal fall in SBP is related to poor allograft function, high chronic vascular score, and high resistive index irrespective of allograft fibrosis. Further studies are needed to determine whether restoration of normal BP pattern will confer better allograft outcome. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Diurnal Blood Pressure Changes One Year after Kidney Transplantation: Relationship to Allograft Function, Histology, and Resistive Index.
肾移植一年后日间血压的变化：与移植肾功能，组织学改变和阻力指数的相互关系。
Loss of circadian BP change has been linked to target organ damage and accelerated kidney function loss in hypertensive patients with and without chronic kidney disease.
Ambulatory BP-derived data from 119 consecutive kidney transplant recipients who presented for the first annual evaluation were examined in relation to allograft function, histology, and ultrasound findings.
在伴有和不伴有慢性肾脏疾病的高血压患者中血压昼夜节律正常变化规律的丧失与靶器官损害和肾功能进行性减退有关。本研究分析了119例肾移植患者移植后第一年随访时动态血压资料与移植肾功能、组织学变化和超声发现之间的关系。
A total of 101 (85%) patients were receiving antihypertensive medications (median 2), and 85 (71%) achieved target awake average systolic BP (SBP) of <135 mmHg.
101例（85%)）患者接受了降压药物治疗（平均两种药物），其中85例 (71%) 平均晨时收缩压血压<135 mmHg。
A day-night change in SBP by 10% or more (dippers) was detected in 29 (24%). Dipping status was associated with younger recipient age, lack of diabetes, low chronic vascular score, and low resistive index.
29例 (24%)昼夜收缩压差在10% 或以上（勺型）。这种勺型状态与年龄较轻、不伴有糖尿病、慢性血管疾病积分较低以及阻力指数低有关。
Nondippers and reverse dippers had lower GFR compared with dippers (P = 0.04). For every 10% nocturnal drop in SBP, GFR increased by 4.6 ml/min per 1.73 m(2) (R = 0.3, P = 0.003).
与勺型高血压患者相比，非勺型和倒勺型患者肾小球滤过率（GFR）较低（P = 0.04）。夜间收缩压每降低10% ，GFR则上升4.6 毫升/分钟/ 1.73 m2 (R = 0.3, P = 0.003).。
Nondippers and reverse dippers were equally common in recipients with normal histology and in those with pathologic findings on surveillance biopsy.
在监测性肾活检显示组织学正常或不正常的患者中非勺型和倒勺型同样常见。
On multivariate analysis, percentage of nocturnal fall in SBP and elevated resistive index independently correlated with GFR.
多变量分析显示：夜间收缩压下降百分比和阻力指数增高分别与GFR独立相关。
This study indicates that lack of nocturnal fall in SBP is related to poor allograft function, high chronic vascular score, and high resistive index irrespective of allograft fibrosis. Further studies are needed to determine whether restoration of normal BP pattern will confer better allograft outcome.
该研究表明夜间收缩压下降规律的丧失与移植肾功能差、慢性血管疾病积分高以及阻力指数高有关，而与移植肾纤维化无关。需要进一步的研究来证实恢复正常血压变化规律是否能改善移植肾的预后。
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作者:admin@医学,生命科学 2010-11-27 05:11
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