维持性血液透析患者收缩压变异性升高的危险因素分析

Risk factors of elevated systolic blood pressure variability in maintenance hemodialysis patients

目的:探讨并分析导致维持性血液透析(MHD)患者收缩压变异性(SBPV)升高的危险因素。方法:选取2020年7月1日至31日在溧水区中医院进行MHD的69例终末期肾病患者作为研究对象。在对这些患者进行MHD期间,观察其收缩压变异系数(SBP-CV)的变化情况,并将其中SBP-CV<7.73%的患者设为低SBPV组,将其中SBP-CV≥7.73%的患者设为高SBPV组。对两组患者的病历资料进行对比分析,总结导致其SBPV升高的危险因素。结果:在透析的过程中,这69例患者平均的SBP-CV为(7.73±3.84)%。与低SBPV组患者相比,高SBPV组患者接受透析的时间更长,其透析液的温度和血清铁蛋白的水平均更高,其中患有糖尿病患者的占比和接受低通量透析患者的占比均更高,差异有统计学意义(P<0.05)。对导致MHD患者SBPV升高的相关因素进行多因素回归分析的结果显示,其接受透析的时间长、透析液的温度高、合并有糖尿病、血清铁蛋白的水平升高及接受低通量透析是导致其SBPV升高的危险因素。结论:导致MHD患者SBPV升高的危险因素主要是其接受透析的时间长、透析液的温度高、合并有糖尿病、血清铁蛋白的水平升高及接受低通量透析。

Objective:To investigate and analyze the risk factors for the increase of systolic blood pressure variability(SBPV)in maintenance hemodialysis(MHD)patients.METHODS:A total of 69 patients with end-stage renal disease who underwent MHD in Lishui District Traditional Chinese Medicine Hospital on July 1,2020 were selected as the research subjects.During the period of MHD,the change of systolic blood pressure coefficient of variation(SBP-CV)was observed in these patients,and the patients with SBP-CV<7.73%were set as the low SBPV group,and the patients with SBP-CV≥7.73%were set as the high SBPV group.The medical records of the two groups of patients were compared and analyzed to summarize the risk factors leading to the elevation of SBPV.Results:In the course of dialysis,the average SBP-CV of the 69 patients was(7.73±3.84)%.Compared with patients in the low SBPV group,patients in the high SBPV group received dialysis for a longer time,the dialysate temperature and serum ferritin level were higher,and the proportion of patients with diabetes and patients receiving low throughput dialysis were higher,the difference was statistically significant(P<0.05).Multivariate regression analysis of the related factors leading to the increase of SBPV in MHD patients showed that the risk factors for the increase of SBPV were long time of dialysis,high temperature of dialysate,diabetes mellitus,elevated serum ferritin level and low throughput dialysis.Conclusion:The risk factors leading to the increase of SBPV in MHD patients are mainly the long time of dialysis,high temperature of dialysate,diabetes mellitus,elevated serum ferritin level and low throughput dialysis.