糖尿病肾病患者透析过程中高血压的影响因素

Risk factors for hypertension during dialysis in patients with diabetic nephropathy

目的研究糖尿病肾病维持性血液透析人群透析过程高血压的相关影响因素。方法对本中心新进人规律血液透析的103例糖尿病肾病患者进行横断面研究,回顾性分析透析过程中出现高血压患者的临床特点,观察所有患者在1个月透析过程中的血压变化,分析影响透析过程中高血压的影响因素。对单因素进行logistic回归建模后可得到影响因素的COR值以及对应的置信区间。将P<0.05的因素纳入多因素logistic模型中,采用前进法得到最后的模型。结果血压平稳组和血压升高组的影响因素中包括平均超滤量、透析液钠浓度、身高、血红蛋白、血钙、血清白蛋白、三酰甘油、尿量比较,差异有统计学意义(P<0.05)。logistic多因素分析结果显示:平均超滤量、身高、血钙、血红蛋白与与透析过程中的高血压具有相关性(P<0.05)。结论超滤量低、贫血、低血钙、较大的身高是维持性血液透析患者透析过程中高血压的危险因素。

Objective To study the related influencing factors of hypertension during dialysis in diabetic nephropathy maintenance hemodialysis patients.Methods A cross-sectional study was performed on 103 patients with diabetic nephropathy who were newly admitted to regular hemodialysis.The clinical features of hypertensive patients during dialysis were retrospectively analyzed.The blood pressure of 103 patients undergoing maintenance hemodialysis during one month of dialysis was observed.The factors affecting the impact of hypertension during dialysis were analyzed.After the logistic regression modeling of single factor,the COR value of the influencing factors and the corresponding confidence interval can be obtained.Factors with P<0.05 were included in the multivariate logistic model,and the final model was obtained using the forward method.Results The influencing factors of blood pressure stable group and blood pressure elevated group included average ultrafiltration volume,dialysate sodium concentration,height,hemoglobin,serum calcium,serum albumin,triacylg-lycerol and urine volume,and the differences were statistically significant(P<0.05).Logistic multivariate analysis showed that the average ultrafiltration volume,height,serum calcium and hemoglobin were correlated with hypertension during dialysis(P<0.05).Conclusions Low ultrafiltration,anemia,hypocalcemia,anti large height are risk factors for hypertension in the dialysis process of maintenance hemodialysis patients.