目的：观察慢性肾脏病患者维生素D水平是否与夜间血压变化相关。方法：纳入2019年6月至2020年2月在我院住院的慢性肾脏病患者120例,其中男性62例,女性58例。平均年龄（55.22±14.33）岁。根据维生素D的水平不同将患者分为3组：≤20 mg/L为维生素D缺乏组;21~29 mg/L为维生素D不足组;≥30 mg/L为维生素D充足组。比较3组患者的人口学特征和临床资料及血压相关指标,同时对维生素D浓度与各变量间的相关性进行分析。结果：维生素D缺乏组（n=40）和不足组（n=45）24 h收缩压、24 h舒张压、夜间收缩压、夜间舒张压均高于维生素D充足组（n=35）,而夜间血压下降率低于维生素D充足组（均P<0.05）。维生素D水平与钙（r=-0.259, P=0.026）、24 h收缩压（r=-0.657, P=0.036）、夜间舒张压（r=-0.203, P=0.000）、夜间收缩压（r=-0.198, P=0.000）呈负相关,与夜间收缩压下降率呈正相关（r=0.291, P=0.000）。多元Logistic回归分析结果显示,维生素D缺乏或不足是慢性肾脏病患者夜间高血压的危险因素（P=0.037）。随着血清维生素D水平的降低,夜间高血压下降率减少。结论：慢性肾脏病患者维生素D水平与24 h收缩压、24 h舒张压、夜间收缩压、夜间舒张压呈负相关,与夜间血压下降率呈正相关。

Objective To observe whether vitamin D level is related to changes of blood pressure in the patients with chronic kidney disease. Methods A total of 120 patients (62 male and 58 female) with chronic kidney disease [age, 18-80(55.22±14.33) years] were enrolled. The patients were divided into 3 groups based on their vitamin D concentration, including very low vitamin D group (≤20 mg/L), low vitamin D group (21-29 mg/L) and vitamin D sufficient group (≥30 mg/L). The clinical data and blood pressure of 3 groups were compared, and the correlation between vitamin D concentration and each variable was analyzed. Results The levels of 24-h systolic blood pressure, 24-h diastolic blood pressure, daytime systolic blood pressure, daytime systolic blood pressure, nocturnal systolic blood pressure, and nocturnal diastolic blood pressure in very low vitamin D group (n=40) and low group (n=45) were higher than those in vitamin D sufficient group(n=35)（all P<0.05）, but the dropping rate of blood pressure at night in two groups were lower than the vitamin D sufficient group. It showed that vitamin D level had negative linear correlation with calcium concentration（r=-0.259, P=0.026）, 24-h systolic blood pressure（r=-0.657, P=0.036）, 24-h diastolic blood pressure, nocturnal diastolic blood pressure（r=-0.203, P=0.000）, nocturnal systolic blood pressure（r=-0.198, P=0.000）.However, vitamin D level was positively correlated with the dropping rate of blood pressure at night. Multivariate Logistic regression analysis showed that vitamin D was a risk factor for the development of nocturnal hypertension in the patients with chronic kidney disease(P=0.037). As serum vitamin D levels decreased, the dropping rate of nocturnal hypertension decreased. Conclusions In the patients with chronic kidney disease,vitamin D level was negatively correlated with 24-h systolic blood pressure, 24-h diastolic blood pressure, nocturnal systolic blood pressure, and nocturnal diastolic blood pressure, but it was positively correlated with the dropping rate of blood pressure at night.