维持性血液透析患者透析中血压变异性的相关因素分析

Related factors of blood pressure variability in maintenance hemodialysis patients during dialysis

目的探讨维持性血液透析患者透析过程中影响血压变异性的危险因素。方法以透析过程中的收缩压BPV、舒张压BPV为应变量,以年龄、干体重、体重指数(BMI)、透析龄、透析前收缩压、平均透析间期体重增长率(IDWG%)、平均脱水量、尿素清除指数(Kt/V)、血红蛋白(Hb)、白蛋白(Alb)、总胆固醇(TC)、甘油三酯(TG)、血清钙(Ca)、磷(P)、全段甲状旁腺激素(iPTH)等为自变量进行多元线性回归分析。结果高BPV组患者的年龄、平均IDWG%、平均脱水量、透析前收缩压均高于低BPV组,血红蛋白、白蛋白水平低于低BPV组。收缩压BPV的独立影响因素为年龄、透析前收缩压、IDWG%、Hb水平,收缩压BPV与年龄、透析前收缩压、IDWG%呈正相关,而与Hb水平呈负相关,舒张压BPV的独立影响因素为IDWG%、平均脱水量。舒张压BPV与患者的IDWG%、平均脱水量呈正相关。结论年龄、透析间期体重增长率、脱水量、透析前收缩压、血红蛋白、白蛋白的变化对于BPV的影响可能会大于不同降压药物的影响。患者应在透析前积极控制血压与透析间期体重增长,适当纠正贫血可能对透析中保持血压平稳有利。

Objective To explore related factors of blood pressure variability in maintenance hemodialysis patients during dialysis. Methods With systolic blood pressure and diastolic blood pressure BPV during dialysis as the depen- dent variable, with age, weight, BMI, dialysis ageas, the average systolic blood pressure, the average weight of the ID- WG%, The average amount of dehydration, Kt/V, Hb, Alb, TC, TG, Ca, P,iPTH as the independent variable. The above data was analyzed by multiple linear regression. Results The value of the average patient age, predialysis systolic blood pressure,the average IDWG%, dehydration, low systolic blood pressure were higher than low BPV group, Hb, Alb levels were lower than low BPV group. Independent factors of systolic blood pressure BPV were age, systolic blood pressure before dialysis, IDWG%, Hb level. Systolic blood pressure BPV and age, systolic blood pressure before dialy- sis, IDWG% were positively correlated, and Hb level were negatively related. Independent factors of diastolic blood pressure BPV were IDWG% and average amount of dehydration. Conclusion Age ,the average weight of the IDWG%, the average amount of dehydration, systolic blood pressure before dialysis, Hb,Alb,changes for BPV may be greater than the impact of different antihypertensive drugs. Patients should be actively controlling blood pressure and weight gain between dialysis, dialysis may be appropriate to correct anemia remain favorable blood pressure was stable.