维持性透析患者透析后血压变异的危险因素研究

Risk Factors of Pressure Variability After Dialysis in Maintenance Hemodialysis

目的:探讨维持性透析(MHD)患者透析后6 h内血压变异增加的危险因素。方法:选择稳定透析患者123例,根据患者透析后6 h的血压的变异度(BPV)分为收缩压高变异组(HSBPV)及收缩压低变异组(LSBPV)、舒张压高变异组(HDBPV)及舒张压低变异组(LDBPV),分析患者血压变异度的影响因素。结果:透析后6 h患者SBPV为(12.56±2.38)%、DBPV为(12.60±3.04)%。在高收缩压变异组与低收缩压变异两组的年龄、干体重、单次透析超滤量、细胞外液(ECW)、细胞内液(ICW)、血红蛋白、i PTH、TC差异有统计学意义(P<0.05),高舒张压变异组与低舒张压变异两组的年龄、干体重、单次透析超滤量、ECW、ICW、血红蛋白、i PTH、TC差异有统计学意义(P<0.05)。干体重、ECW、血红蛋白、i PTH、TC是MHD患者透析后收缩压变异度的独立危险因素(P<0.05),年龄、TC是MHD患者透析后舒张压变异度的独立危险因素(P<0.05)。结论:透析前细胞外液高容量、低血红蛋白血症、高胆固醇血症、炎症状态及未得到控制的继发性甲旁亢可增加MHD患者透析后6 h的收缩压变异度;高龄、高胆固醇血症可增加MHD患者透析后8 h的舒张压的变异度。

Objective： To explore the risk factors of blood pressure variability（ BPV） increasing for the undergoing maintenance hemodialysis（ MHD） patients in the 6 hours after dialysis. Methods： A total of 123 cases of hemodialysis patients,According to the blood pressure variability（ BPV） in 6 hours after dialysis,123 cases were divided High SBPV（ HSBPV） group and Low SBPV（ LSBPV） group,divided High DBPV（ HDBPV） group and Low DBPV（ LDBPV） group. All the suspicious factors were analyzed.Results： After dialysis,age,dry weight,ultrafiltration volume,extracellular fluid volume（ ECW）,intracellular fluid volume（ ICW）,hemoglobin,i PTH,TC were statistically significance difference（ P〈0. 05） in the comparison between HSBPV group and LSBPV group. Age,dry weight,ultrafiltration volume,ECW,ICW,hemoglobin,i PTH,TC were statistically significance difference（ P〈0. 05） in the comparison between HSBPV group and LSBPV group. The independent risk factors（ P〈0. 05） of the SBPV in the6 hours after dialysis were dry weight,hemoglobin,i PTH,TC. And the age,TC were the independent risk factors（ P〈0. 05） of the DBPV. Conclusion： Dry weight,hemoglobin,i PTH,TC are make a contribution to the increasing of SBPV,and age,TC are make a contribution to increasing diastolic blood pressure during dialysis.