维持性血液透析患者体质量指数与动脉粥样硬化、血压的相关性分析

The analysis of correlation of body mass index and atherosclerosis blood pressure in patients with maintenancehemodialysis

目的探讨维持性血透（MHD）患者体质量指数（BMI）与动脉硬化、血压（BP）的关系，进一步阐明MHD患者心血管疾病的发病机制。方法对101例MHD患者的血压（BP）、内膜．中层厚度（IMT）和BMI进行相关性分析。结果8％的患者透析后收缩压超过150mmHg，21％的患者舒张压超过90mmHg，与一般人群相反，BP和BMI之间存在负相关（r=-0．13，P〈0．01）。体质量不足（BMI〈20）患者中的高血压患者超过了正常体质量（BMI20．0-27．5）和超重患者（BMI〉27．5），分别为35％、29％和20％。单因素回归分析示BP与BMI（r=-0．12，P〈0．01）呈负相关，IMT与BMI呈正相关（r=0．411，P〈0．05）。结论在持续性血透患者中营养不良与动脉粥样硬化和高血压的发生和发展有显著的相关性，BMI下降是心血管疾病发病率和病死率增加的独立危险因素。

Objective To explore the relationship of body mass index （BMI） and atherosclerosis, blood pressure （BP） in patients with maintenance hemodialysis（ MHD）, to further elucidate the pathogenesis of cardiovascu- lar disease in MHD patients. Methods The relationship between BP, intima-medial thickness （IMT） and BMI was analyzed in 101 patients with MHD. Results After dialysis,38% patients had systolic blood pressure over 150mm Hg,21% had diastolic blood pressure of more than 90mm Hg. Contrary to the general population, the correlation be- tween BP and BMI were negatively（ r = -0.13 ,P 〈 0.01 ）. Hypertension in patients with BMI 〈 20 were more than that in patients with a normal body weight（ BMI 20.0 - 27.5 ） and overweight patients （ BML 〉 27.5 ）, and the rate was 35% ,29% and 20% ,respectively. Univariate analysis showed that BP and BMI were negatively correlated（ r = - 0. 12, P 〈 0. 01 ）, IMT was positively correlated with BMI （ r = 0.411, P 〈 0.05 ）. Conclusion In persistent hemodialysis patients, malnutrition was correlated with the occurrence and development of atherosclerosis and hypertension, and BMI decreasing was an independent risk factor, which could increase the morbidity and mortality of cardiovascular disease.