MHD患者透析期间血压波动与其骨代谢指标的相关性

Correlation Between Blood Pressure Fluctuation and Bone Metabolism Indicators in MHD Patients During Dialysis

目的研究MHD患者透析期间血压波动与其骨代谢指标的相关性。方法选择2017年3月-2021年2月在广东省惠州市第六人民医院接受MHD治疗的透析患者355例作为观察对象。将患者分成观察组(即|△SBP|≥10mmHg)共107例,以及对照组(即|△SBP|<10mmHg)共248例。对比两组透析相关指标,分析MHD患者的骨代谢指标与其血压波动的相关性,利用Logistic回归分析法分析MHD患者自身血压波动的影响因素。结果观察组的血磷(1.98±0.24)mmol/L、iPTH水平(414.61±83.42)pg/mL均分别较对照组(1.79±0.36)mmol/L、(376.53±68.85)pg/mL明显更高(P<0.05)。根据Pearson法分析相关性显示,MHD患者透析期间血压波动|△SBP|值与其血磷及iPTH均呈正相关(P<0.05)。根据Logistic回归分析法发现,MHD患者自身血压波动的危险因素包含血磷,以及iPTH(OR>1)。结论MHD患者透析期间发生血压波动的状况与其骨代谢指标之间的相关性较好,且影响血压波动的因素包含血磷及iPTH,可采取适当的措施加以干预,从而更好地改善患者的预后,应予以重视。

Objective To study the correlation between blood pressure fluctuation and bone metabolism indicators in MHD patients during dialysis.Methods 355 dialysis patients who received MHD treatment in our hospital from March 2017 to February 2021 were selected as observation objects.The patients were divided into observation group(i.e.|△SBP|≥10 mmHg)in 107 cases,and the control group(i.e.|△SBP|<10 mmHg)was 248 cases.By comparison of dialysis related indicators of two groups,the paper made analysis of the relationship between bone metabolism and blood pressure fluctuation in MHD patients,MHD CKD-MBD of blood pressure fluctuation during dialysis with dialysis complications,and Logistic regression analysis was used to analyze the influencing factors of blood pressure fluctuation in MHD patients.Results The blood phosphorus(1.98±0.24)mmol/L and iPTH levels(414.61±83.42)pg/mL in the observation group were significantly higher than those of the control group(1.79±0.36)mmol/L,(376.53±68.85)pg/mL(P<0.05).According to the Pearson analysis,the blood pressure fluctuation|△SBP|value of MHD patients during dialysis was positively correlated with the blood phosphorus and iPTH index(P<0.05).According to Logistic regression analysis,MHD risk factors for blood pressure fluctuations include blood phosphorus,and iPTH(OR>1).Conclusion There is a good correlation between blood pressure fluctuation and bone metabolism related indicators during dialysis in MHD patients,and the factors affecting blood pressure fluctuation include blood phosphorus and iPTH,which can take appropriate measures to intervene.In order to improve the prognosis of patients,we should pay attention to it.