摘要 目的 急性心肌梗死（AMI）合并慢性肾脏病（CKD）患者血压随CKD分期的变化趋势。 方法 连续收集同一中心AMI合并CKD3期、CKD4期和CKD5期的所有患者（n=324）。根据标准法测量的收缩压和舒张压将这些患者分为四个血压类型：正常血压（SBP/DBP＜140/90 mm Hg）、孤立收缩期高血压（ISH，SBP≥140 mm Hg, DBP＜90 mm Hg）、孤立舒张期高血压（IDH, SBP＜140 mm Hg, DBP≥90 mm Hg）和双期高血压（SDH, SBP/DBP≥140/90 mm Hg）。 结果 总体血压控制率为45.7%，而且随着CKD分期逐级降低。孤立舒张期高血压在CKD3期、CKD4期及CKD5期中发生率分别为5.0%、5.3%和0，双期高血压在CKD3期、CKD4期及CKD5期中发生率并没有显著变化（分别为15.0%、14.9%和15.7%），孤立收缩期高血压发生率随着CKD分期逐级升高（分别为28.1%、39.4% 和45.7%）。逻辑回归分析发现，年龄和CKD分期是这些患者孤立收缩期高血压的独立危险因素（CKD5期患者发生孤立收缩期高血压的风险分别是CKD3期和CKD4期的2.13倍和3.99倍）。 结论 AMI合并CKD患者孤立收缩期高血压发生率随着CKD分期逐级升高，而且CKD分期是孤立收缩期高血压发生率升高的危险因素，这也是CKD发展过程中导致心血管事件病死率升高的一部分原因。
李红艳，王龙安，李静宇. 急性心肌梗死合并慢性肾脏病患者血压变化趋势[J]. 中国急救医学, 2019, 39(7): 633-637.
Li Hong-yan, Wang Long-an, Li Jing-yu. Trends of blood pressure in patients with acute myocardial infarction combined with chronic kidney disease. Chinese Journal of Critical Care Medicine, 2019, 39(7): 633-637.
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