维持性血液透析患者心血管事件危险因素相关研究

Study on risk factors of cardiovascular events in maintenance hemodialysis patients

目的了解维持性血液透析患者发生心血管终点事件的相关危险因素。方法选取2019年1月-2020年12月在邵阳学院附属第一医院及附属第二医院368例维持性血液透析(maintenance hemodialysis,MHD)患者,分析年龄、性别、文化程度、婚姻情况、生育子女数、医疗支出、医疗保险支付方式、终末期肾病的原因、日常生活能力、心理、透析龄、透析频次、高通量透析器使用频次、透析过程中常见并发症(发生低血糖次数、发生肌肉痉挛次数)、使用降压药、促红细胞生成素与MHD发生心血管事件的相关性。结果高龄、糖尿病肾病、使用β受体阻滞剂是MHD患者发生心血管事件可能的独立危险因素,0R值(95%CI)分别为2.523(1.683-20.144),0.374(0.177-0.790),6.490(1.142-36.892),1.923(1.051-3.517)。结论从生物-行为-心理因素方面,针对危险因素有效的预防,根据本研究,提出防治策略可以减少维持性血液透析患者发生心血管事件的发生。

Objective To investigate the influencing factors of cardiovascular events in maintenance hemodialysis(MHD)patients.Methods A total of 368 patients with maintenance hemodialysis,who admitted into the First Affiliated Hospital of Shaoyang College and the Second Affiliated Hospital of Shaoyang College during January 2019 to December 2020.observed and analyzed the relationgship between the cardiovascular events with the factors that include age,sex,educational level,marital status,numbers of children born,medical expenses,different kinds of medical insuranre,causes of end-stage Renal disease,the rapacity of living,quality of life,psychological status,times of the MHD,the frequency of useing high-flux dialyzer,the times of intradialytic hypotension and Muscle spasm,useing the drug of Erythropoietin and Beta blockers.Results The study considers that ages,the cause of the diabetic nephropathy,the drug of Beta blockers are risks factors for cardiovascular events in maintenance hemodialysis patients by binary logistic regression analysis.Conelusion From the aspect of biological-behavioral-psychological factors,according to this study,we can take the prevention and treatment strategy that can reduce the occurrence of cardiovascular events in maintenance hemodialysis patients.