维持性血液透析患者透析所致血压异常的相关因素分析

Analyses on the factors relating to the abnormal blood pressure in maintenance hemodialysis patients

目的探讨维持性血液透析（maintenance hemodialysis,MHD）患者透析所致血压异常的相关因素。方法选择2012年10月—2014年6月收治的125例MHD患者作为研究对象。根据患者血压监测情况分为A组70例和B组55例。观察对比两组患者年龄、性别、体质指数、透析龄、干体重达标情况、KT/V值、透析次数、促红细胞生成素用药剂量、遵循医嘱使用降压药物情况等一般资料。计量资料采用t检验,计数资料采用χ2检验,对单因素分析后存在显著性差异的指标行非条件Logistic回归分析,P〈0.05为差异有统计学意义。结果 KT/V值〈1.2（OR=4.196,95%CI为1.761~9.546）、体重≥干体重的10%（OR=3.442,95%CI为1.486~7.268）、透析次数〈2次/周（OR=4.295,95%CI为1.834~10.634）及未遵循医嘱使用降压药物（OR=3.953,95%CI为1.635~8.681）是影响MHD患者出现血压异常症状的独立危险因素。结论 KT/V值〈1.2、体重≥干体重的10%、透析次数〈2次/周、未遵循医嘱使用降压药物等为MHD患者出现透析致血压异常的独立危险因素,应当引起临床的广泛关注。

Objective To analysis the factors relating to the abnormal blood pressure in maintenance hemodialysis（MHD） patients. Methods 125 cases of MHD from October 2012 to June 2014 were selected.Divide the patients into group A（n=70） and group B（n=55） according to the blood pressure.The general information such as age,gender, BMI,dialysis age,dry weight,KT/V,number of dialysis,erythropoietin dosage,and condition of follow the doctor＇s advice to use antihypertensive drugs were recorded and com- pared.Measurement data was processed by t test,count data was processed by chi square test,significant differences factors after single factor analysis of index rows unconditioned Logistics regression analysis,P〈0.05 was considered statistically significant. Results KT/V〈1.2（OR=4.196,95%CI 1.761-9.546）,weight≥ 10% dry weight（OR=3.442,95%Cl 1.486-7.268）,number of dialy- sis〈2 times/week（OR=4.295,95%Cl 1.834-10.634）,use of antihypertensive drugs in did not follow the doctor＇s advice（OR=3.953, 95%CI 1.635-8.681） were the independent factors influencing abnormal blood pressure of MHD patients.Conclusion KT/V〈1.2, weight t〉 10% dry weight,number of dialysis〈2 times/week,use of antihypertensive drugs in did not follow the doctor＇s advice are the independent risk factors of abnormal blood pressure in MHI） patients,should cause clinical attention.