血压变异性与透析患者住院情况的相关性研究

Relationship between blood pressure variability and hospitalization of hemodialysis patients

目的观察维持性血液透析患者血压变异性与入院情况的相关性。方法2012年12月~2014年12月在中国人民解放军西部战区总医院肾内科行维持性血液透析的慢性肾功能不全患者共92例。收集患者一般临床资料(包括实验室检查指标),记录每次血液透析前血压(收缩压、舒张压),分析患者的血压变异性。同时记录患者入院情况,分析患者透析前血压变异性与入院情况的关系。结果透析前收缩压变异性较高的患者年住院频次显著高于透析前收缩压变异性较低的患者(t=2.662,P=0.009)。入院患者的透析前收缩压变异性和透析前舒张压变异性均显著高于未入院患者(t值分别为3.007,4.431;P值分别为0.003,<0.001)。Logistic回归分析显示,透析前高舒张压变异性是患者入院的独立危险因素(OR=2.694,95%CI 1.034~7.023,P=0.043)。结论维持性血液透析患者随诊间血压变异性与患者的入院情况相关。控制透析前血压变异性尤其是舒张压变异性或许有助于减少入院率。

Objective To investigate the relationship between blood pressure variability(BPV)and hospitalization of hemodialysis patients.Methods A total of 92 patients undergoing maintenance hemodialysis(MHD)in the period between Dec 2012 and Dec 2014 were included in this study.Blood pressure was measured during each visit.Visit-to-visit BPV was quantified by calculating the standard deviation(SD).The hospitalization status of the patients was recorded and the relationship between prEdialysis BPV and the hospitalization status was analyzed.Results The annual hospitalization frequency of the patients with high prEdialysis systolic BPV was significantly higher than that of the patients with low prEdialysis systolic BPV(t=2.662,P=0.009).PrEdialysis systolic BPV(t=3.007,P=0.003)and prEdialysis diastolic BPV(t=4.431,P<0.001)were significantly higher in hospitalized patients than in non-hospitalized patients.Logistic regression analysis showed that higher prEdiastolic BPV was the independent risk factor for hospitalization(OR=2.694,95%CI 1.034~7.023,P=0.043).Conclusion The visit-to-visit BPV was related to hospitalization in MHD patients.Controlling prEdialysis BPV,especially the prEdiastolic BPV,may help reduce hospitalization rate in MHD patients.