nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2011-15-4-39-44nefr-658Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSОСОБЕННОСТИ СУТОЧНОГО ПРОФИЛЯ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ У БОЛЬНЫХ С ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ ПРИ НАРУШЕНИИ ФУНКЦИИ ПОЧЕКARTERIAL BLOOD PRESSURE DAILY PROFILE CHARACTERISTICS AT PATIENTS WITH CHRONIC HEART FAILURE AND RENAL DISORDERСЕРОВВ. А.SEROVV. A.

Кафедра терапии и профессиональных болезней медицинского факультета

ШУТОВА. М.SHUTOVA. V.

Кафедра терапии и профессиональных болезней медицинского факультета

ТРОШЕНЬКИНАО. В.TROSHEN’KINAO. V.

Кафедра терапии и профессиональных болезней медицинского факультета

МАКЕЕВАЕ. Р.MAKEEVAYe. R.

Кафедра терапии и профессиональных болезней медицинского факультета

СЕРОВАД. В.SEROVAD. V.

Кафедра терапии и профессиональных болезней медицинского факультета

КУЗНЕЦОВАЮ. С.KUZNETSOVAYu. S.

Кафедра терапии и профессиональных болезней медицинского факультета

Ульяновский государственный университетРоссия2011100420111543944Copyright © СЕРОВ В.А., ШУТОВ А.М., ТРОШЕНЬКИНА О.В., МАКЕЕВА Е.Р., СЕРОВА Д.В., КУЗНЕЦОВА Ю.С., 20112011СЕРОВ В.А., ШУТОВ А.М., ТРОШЕНЬКИНА О.В., МАКЕЕВА Е.Р., СЕРОВА Д.В., КУЗНЕЦОВА Ю.С.SEROV V.A., SHUTOV A.V., TROSHEN’KINA O.V., MAKEEVA Y.R., SEROVA D.V., KUZNETSOVA Y.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/658

ЦЕЛЬ ИССЛЕДОВАНИЯ: изучение особенностей суточного профиля артериального давления (АД) у больных с хронической сердечной недостаточностью (ХСН) в зависимости от функционального состояния почек. ПАЦИЕНТЫ И МЕТОДЫ. Обследовано 184 больных с ХСН (101 мужчина и 83 женщины), средний возраст - 56,7 года. У 20 пациентов был диагностирован I функциональный класс (ФК), у 105 - II., у 58 - III ФК ХСН и у 1 - IV ФК ХСН. Скорость клубочковой фильтрации (СКФ) рассчитывали по формуле MDRD., СКФ в среднем составила 58,6±18,9 мл/мин/1,73 м2. Вариационный ряд СКФ был разделен на квартили. РЕЗУЛЬТАТЫ. Величины офисного АД были выше у больных 4-го квартиля. Выявлена положительная корреляция величины среднесуточных и среднедневных систолического и диастолического АД, индекса времени гипертонии диастолического АД с величиной СКФ. Значительные различия выявлены в степени ночного снижения (СНС) как систолического, так и диастолического АД у больных с ХСН с разной СКФ: у больных с ХСН 1-го квартиля СНС АД была статистически значимо ниже. ЗАКЛЮЧЕНИЕ. Результаты исследования свидетельствуют о существенных нарушениях суточного ритма АД у больных с ХСН, ассоциированной с хронической болезнью почек, которые потенциально могут влиять на прогноз заболевания. Необходимо проведение дальнейших исследований по определению прогностического значения изменений показателей СМАД у больных с ХСН и использование полученной информации для оптимизации лечения

THE AIM: investigation of arterial blood pressure (ABP) daily profile specifications at patients with chronic heart failure (CHF) depending on functional kidneys state. PATIENTS AND METHODS. 184 patients with CHF were searched (101 men and 83 women), average age - 56.7 years. 20 patients were diagnosed I functional class (FC), 105 - II., 58 - III CHF FC and 1 - IV CHF FC. Glomerular filtration rate (GFR) was counted by MDRD formula, average GFR was 58.6±18.9 ml/min/1.73m2. CHF ordered sample was divided into quartiles. RESULTS. Patients from quartile 4 had higher value of ABP. There was shown positive correlation of diurnial and average daily systolic and diastolic ABP., diastolic ABP hypertension time index with CHF value. Meaningful differences were detected in night decreasing level (NDL) of systolic and diastolic ABP at patients of CHF with different GFR: ABP NDL was statically rather lower at patients with CHF from 1 quartile. CONCLUSION. Results of the research testify about appreciable ABP diurnial rhythm disturbances at patients with CHF associated with chronic kidney disease which can potentially affect on disease prognosis. It is necessary to provide further investigations of diurnial ABPM factors alteration prognostic value determination at patients with CHF and usage of received information for treatment optimization

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The authors declare that there are no conflicts of interest present.