维持性血液透析与腹膜透析患者动态血压变化的对比

Comparison of ambulatory blood pressure changes in patients undergoing maintenance hemodialysis and peritoneal dialysis

目的对比血液透析伴高血压患者与腹膜透析伴高血压患者血压波动的特点，为临床治疗及护理提供指导。方法收集选取2014年5月至2016年5月于本院规律血液透析伴高血压患者98例，腹膜透析伴高血压者68例。对其行动态血压检测，观察指标两组间24h平均收缩压（24hSBP）、24h平均舒张压（24hDBP）、日间平均收缩压（dSBP）、日间平均舒张压（dDBP）、夜间平均收缩压（nSBP）和夜间平均舒张压（nDBP）及其下降率。结果腹膜透析伴高血压组杓型血压比例明显高于血液透析伴高血压组（P=0．009）。血液透析伴高血压组24hSBP、24hDBP、nSBP、nDBP高于腹膜透析组伴高血压组（P〈0．05）。血液透析伴高血压组夜间SBP下降率、夜间DBP下降率低于腹膜透析伴高血压组（P〈0．05）。结论血液透析伴高血压患者比腹膜透析伴高血压患者杓型血压比例较少，夜间SBP下降率、夜间DBP下降率低，昼夜节律不明显。在临床工作中医务人员更应该注意血液透析伴高血压患者的血压治疗。

Objective To compare the characteristics of blood pressure fluctuation in hemodialysis patients and peritoneal dialysis patients with hypertension, and to provide guidance for clinical treatment and nursing. Methods 98 hemodialysis patients with hypertension, 68 peritoneal dialysis patients with hypertension from May 2014 to May 2016 were collected from our hospital. The ambulatory blood pressure monitoring was used in the patients. 24hSBP, 24hDBP, dSBP, dDBP, nSBP, nDBP, the decrease rate were compared between two groups. Results The ratio of dipper type blood pressure in hemodialysis group was lower than that in peritoneal dialysis group （P=0.009）. 24hSBP, 24hDBP, nSBP, nDBP in hemodialysis group were higher than those in peritoneal dialysis group （P〈0.05）. The decrease rate of nSBP, nDBP in hemodialysis group were lower than those in peritoneal dialysis group （P〈0.05）. Conclusions The ratio of dipper type blood pressure in hemodialysis patients with hypertension was lower than that in peritoneal dialysis patients with hypertension. The decrease rate of nSBP, nDBP in hemodialysis patients with hypertension were lower. In clinical work, medical staff should pay more attention to the treatment of blood pressure in hemodialysis patients with hypertension.