维持性腹膜透析患者血压变异性的相关影响因素

Factors associated with blood pressure variability in patients on maintenance peritoneal dialysis

目的 本研究旨在探究维持性腹膜透析人群中血压变异性的相关影响因素。方法 选择2019年6月至2020年6月在南阳市中心医院腹膜透析中心规律且随访透析时间大于3个月的142例腹膜透析患者。收集入院腹膜透析评估时的一周晨起收缩压以及其他临床资料。一周收缩压变异性的相关影响因素分析用多重线性回归分析。结果 共142例维持性腹膜透析患者纳入本研究,平均一周收缩压变异系数为(12.56±2.90)%。透析龄每增加1个月,一周收缩压变异性增高0.12%(P=0.01)。血红蛋白每增加1 g/L,收缩压变异性降低0.11%(P=0.01);每日出液量(尿量+超滤量)每增加100 mL/d,一周收缩压变异性约降低1%(P=0.03);含CCB类降压药物与血压变异性呈负相关(P=0.04)。而年龄、性别、血白蛋白、血钙、血磷、甲状旁腺激素、腹膜性质、透析充分性(Kt/V值)、磷结合剂、人促红细胞生成素应用等与一周收缩压变异性无明显相关(P>0.05)。结论 维持性腹膜透析人群一周收缩压变异性可能与透析龄呈正相关,而与血红蛋白、每日出液量、含CCB类降压药物呈负相关。

Objective To explore the related factors of weekly blood pressure variability(BPV)on maintenance peritoneal dialysis(MPD).Methods A total of 142 patients on MPD for at least 3 months were recruited.Blood pressure was assessed weekly by variation coefficient(CV)of systolic blood pressure in morning.The relevant clinical data was collected.The association of BPV and predictors were estimated by a mixed-effect linear model.Results Longer dialysis vintage was associated with elevated weekly BPV(P<0.05).The higher hemoglobin concentration,the greater daily fluid removal.And dosing of calcium antagonists was associated with attenuated weekly BPV(P<0.05).However,other factors(age,gender,albumin,serum calcium,serum phosphorus,parathyroid hormone,peritoneal transport features,dialysis adequacy,phosphate binders&erythropoietin)were not(P>0.05).Conclusions Weekly BPV may be affected by dialysis vintage,hemoglobin concentration,daily fluid removal and dosing of calcium antagonists.