首页|24小时尿蛋白、血压变异性与原发性高血压患者发生睡眠障碍的关系

24小时尿蛋白、血压变异性与原发性高血压患者发生睡眠障碍的关系

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目的:分析24 h尿蛋白定量(24 h-UTP)、血压变异性(BPV)与原发性高血压(EHT)患者发生睡眠障碍的关系。方法:选取2017年6月至2019年12月玉林市第一人民医院接受治疗的200例EHT患者作为研究对象,均接受降压治疗1个月,于治疗前检测患者24 h-UTP,检测血压并计算血压变异系数[收缩压变异系数(SCV)、舒张压变异系数(DCV)],治疗1个月经匹兹堡睡眠质量指数(PSQI)量表评定睡眠质量并分组,分析治疗前24 h尿蛋白、血压变异系数与EHT患者发生睡眠障碍的关系。结果:EHT患者治疗前24 h-UTP为44.01(42.41,45.50)mg/24 h,SCV为11.53(10.87,12.22),DCV为7.75(7.38,8.10);治疗1个月PSQI评分为6.50(3.00,7.00)分;相关性分析结果显示,24 h-UTP与PSQI评分呈负相关(r=-0.763,P<0.05);SCV、DCV分别与PSQI评分之间呈正相关(r=0.815、0.759,P<0.05);经1个月治疗,200例患者中发生睡眠障碍的患者有49例,发生率为24.50%;经回归分析检验结果显示,SCV(OR=1.580,P=0.021)、DCV(OR=1.592,P<0.001)、24 h-UTP(OR=1.403,P<0.001)高可能是EHT患者治疗后发生睡眠障碍的风险因子。绘制受试者工作特征(ROC)曲线,结果显示,治疗前SCV、DCV、24 h-UTP分别预测EHT患者治疗后发生睡眠障碍风险的AUC分别为0.822(95%CI:0.757~0.888)、0.856(95%CI:0.783~0.928)、0.863(95%CI:0.787~0.938),预测价值均较理想。结论:24 h-UTP、BPV与EHT患者睡眠质量有关,可能是患者治疗后发生睡眠障碍的风险因子,对预测患者治疗后发生睡眠障碍风险有一定价值。
Relationship of 24-hour urinary protein and blood pressure variability with sleep disorders in patients with essential hypertension
Objective:To analyze the relationship of 24-hour urinary protein quantification (24 h-UTP) and blood pressure variability (BPV) with sleep disorders in patients with essential hypertension (EHT).Methods:A total of 200 patients with EHT who were treated at Yulin First People's Hospital from June 2017 to December 2019 were selected as the research subjects. All patients received antihypertensive treatment for 1 month. Before treatment, 24 h-UTP was detected, blood pressure was measured, and blood pressure variation coefficients [coefficient of variation of systolic blood pressure (SCV) and coefficient of variation of diastolic blood pressure (DCV)] were calculated. After 1 month of treatment, the Pittsburgh sleep quality index (PSQI) scale was used to evaluate sleep quality, and the patients were grouped based on the sleep quality. The relationship of 24 h-UTP and blood pressure variation coefficients with sleep disorders in EHT patients was analyzed.Results:The 24 h-UTP of EHT patients was 44.01 (42.41, 45.50) mg/24 h before the treatment, the SCV was 11.53 (10.87, 12.22), and the DCV was 7.75 (7.38,8.10). The PSQI score of the patients after 1 month of treatment was 6.50 (3.00,7.00) points. The results of correlation analysis showed that there was a negative correlation between 24 h-UTP and PSQI score (r=-0.763, P<0.05). There was a positive correlation between SCV and DCV and PSQI score (r=0.815 and 0.759, respectively, P<0.05). After one month of treatment, 49 of the 200 patients (24.50%) had sleep disorders. The results of regression analysis showed that high SCV (OR=1.580, P=0.021), DCV (OR=1.592, P<0.001), and 24 h-UTP (OR=1.403, P<0.001) might be risk factors for sleep disorders in EHT patients after treatment. The receiver operator characteristic (ROC) curve was drawn and the results showed that the area under the curve (AUC) values of SCV, DCV, and 24 h-UTP in predicting the risk of sleep disorders in EHT patients after treatment was 0.822 (95%CI: 0.757-0.888), 0.856 (95%CI: 0.783-0.928), and 0.863 (95%CI: 0.787-0.938), respectively, and the predictive value was satisfactory.Conclusion:24 h-UTP and BPV are related to the sleep quality in patients with EHT, which may be risk factors for sleep disorders in the patients after treatment, and they have appreciated value in predicting the risk of sleep disorders in patients after treatment.

曾书燚、梁祥文、林智海、黎艺毅、凌政、王正东

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537000 玉林,玉林市第一人民医院心血管内科

原发性高血压 24 h尿蛋白定量 血压变异性 睡眠障碍 相关性

2023

中华临床医师杂志(电子版)
中华医学会

中华临床医师杂志(电子版)

CSTPCD
影响因子:0.99
ISSN:1674-0785
年,卷(期):2023.17(1)
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