维持性血液透析患者透析中血压变异性及其相关因素的横断面调查  

Cross-sectional investigation of the intradialytic blood pressure variability and its related factors in maintenance hemodialysis patients

作　　者：胡英 孙尚萍[1,3] 甘良英 杨冰 王磊[1] 蔡美顺[1] 左力[1] HU Ying;SUN Shang-ping;GAN Liang-ying;YANG Bing;WANG Lei;CAI Mei-shun;ZUO Li(Department of Nephrology,Peking University People's Hospital Beijing 100044,China;Department of Nephrology,The People's Hospital of Guizhou Province,Guiyang 550002,China;Department of Nephrology,The Traditional Chinese Medicine Hospital of Zunyt Zunyi 563000,China)

机构地区：[1]北京大学人民医院肾内科,北京100044 [2]贵州省人民医院肾内科,贵阳550002 [3]贵州省遵义市中医医院肾内科,遵义563000

出　　处：《中国血液净化》2019年第8期531-534,共4页Chinese Journal of Blood Purification

摘　　要：目的 探讨影响维持性血液透析患者透析中血压变异性的相关因素.方法 收集北京大学人民医院血液透析室维持性透析患者2017年10月1日~10月31日人口学资料、生化、超声心动结果及透析中的血压数据.以透析中的收缩压变异性(systolic blood pressure variability,SBPV)、舒张压变异性(diastolic blood pressure variability,DBPV)为因变量,以年龄、透析龄、及心脏相关参数等为自变量进行分析. 结果 入选维持性透析患者111例.透析中收缩压变异性与患者年龄、超滤量、全段甲状旁腺素水平呈正相关(r值分别为0.332,0.261,0.375;P值分别为<0.001,0.030,0.003),与肌酐呈负相关(r=-0.212,P=0.013).DBPV与舒张期末左心室质量指数呈正相关(r=0.199,P=0.040).在校正超滤量、全段甲状旁腺素、肌酐等影响因素后,SBPV与年龄呈正相关(t=2.911,P=0.004). 结论 年龄是透析中收缩压变异性的独立危险因素,舒张期末左心室质量指数可能受血压变异性影响.Objective To explore the factors relating to intradialytic blood pressure variability and to analyze the relationship between blood pressure variability and cardiac functional indices in maintenance hemodialysis(MHD)patients.Methods MHD patients treated in the Hemodialysis Division of Peking University People’s Hospital from October 1 to 31,2017 were recruited.Their demographic data,biochemical examinations,echocardiography and intradialytic blood pressure were collected.Pearson and multivariate regression analyses were performed using intradialytic systolic blood pressure variability(SBPV)and diastolic blood pressure variability(DBPV)as the dependent variables,and age,dialysis age and cardiac functional indices as the independent variables.Results A total of 111 MHD patients were recruited in this study.The intradialytic SBPV was positively correlated with patient age(r=0.332,P=0.000),ultrafiltration volume(r=0.261,P=0.049)and iPTH(r=0.375,P=0.003),and was negatively correlated with creatinine level(r=-0.212,P=0.013).The intradialytic DBPV was positively correlated with end-diastolic left ventricle mass index(LVMI)(r=0.199,P=0.040).The intradialytic SBPV was positively correlated with age(t=2.911,P=0.004)after the adjustment of ultrafiltration volume,iPTH and creatinine.Conclusion The age of MHD patients was an independent risk factor for intradialytic SBPV,and the intradialytic DBPV influenced the end-diastolic left ventricle mass index in these patients.

关 键 词：血压变异性 舒张期末左心室质量指数 血液透析 

分 类 号：R318.16[医药卫生—生物医学工程]