透析性低血压危险因素分析  

Analyze the Risk Factors of Hemodialysis Associated Hypotension

作　　者：鲍晓荣[1] 杜国伟[1] 

机构地区：[1]复旦大学附属金山医院肾内科,上海200540

出　　处：《中国临床医学》2008年第6期840-841,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:分析透析性低血压的危险因素。方法:根据透析性低血压诊断标准,将本院使用同一型号血透机、年龄相匹配的33例维持性血透患者分为低血压组(n=12)和非低血压组(n=21),比较两组间原发病因、透龄、透析前干体重(DBW)、超滤量(UF)、UF/DBW、血红蛋白(Hb)、血浆白蛋白(Alb)、C反应蛋白(CRP)和左室质量指数(LVMI)等资料的差异,采用Spearman等级相关分析法分析透析性低血压与上述诸因素的相关性。结果:(1)低血压组糖尿病肾病病例明显多于非低血压组(P<0.05);(2)与非低血压组相比,低血压组UF、UF/DBW明显增高(P<0.01,P<0.05),但两组间DBW无明显差异;(3)与非低血压组相比,低血压组Hb、Alb显著低下(P<0.01,P<0.05),CRP和LVMI显著增高(均P<0.01);(4)相关分析显示,透析性低血压与UF(r=0.258,P<0.05)、UF/DBW(r=0.314,P<0.01)、CRP(r=0.458,P<0.01)、LVMI(r=0.358,P<0.01)呈显著正相关,与Hb(r=-0.348,P<0.01)、Alb(r=-0.269,P<0.05)呈显著负相关。结论:原发病为糖尿病肾病、严重贫血、低蛋白血症、炎症状态、左室肥厚及超滤量过多是透析性低血压发生的重要危险因素。Objective：To analyze the risk factors of hemodialysis associated hypotension. Methods： According to the diagnostic standard of hemodialysis associated hypotension, 33 maintained hemodialysis patients in our hospital were divided into two groups： low blood pressure group （LBP, n = 12） and no low blood pressure group （NLBP, n = 21）. The clinical data, including primary disease, dialysitic duration, body dry weight（DBW）, ultrafiltration（UF）, UF/DBW, hemoglobin（Hb）, albumin （Alb）, c reactive protein（CRP）, and left ventricular mass index（LVMI）, were compared between two groups. The correlation was analyzed with Spearman rank correlation. Results： （1）The percentage of diabetic nephropathy in the 1.BP group was signifi cant higher than that in the NLBP one （P〈0.05）. （2） UF and UF/DBW in the LBP group were significant higher than those in the NLBP one, but there was no difference in DBW between two groups. （3） Compared with the NLBP group, the levels of Hb and Alb in the LBP one were significantly lower （P〈0.01, P〈0.05）, but the levels of CRP and LVMI were significant higher in the LBP group （P〈0.01）. （4） Regression analysis showed that hemodialysis associated hypotension had significant positive correlations with UF（rs = 0. 258,P〈0.05）,UF/DBW（rs = 0. 314,P〈0. 01）,CRP（r = 0. 458,P〈0.01 ）,LVMI（r = 0. 358,P〈0.01 ）, hut negative correlations with Hb（r= -0. 348,P〈0.01 ）and Alb（r= -0. 269, P〈0.05）. Conclusion：Diabetic nephropathy, serious anemia, hypoproteinemia, inflammation state, left ventricular hypertrophy and too much ultrafiltration are all important risk factors of hemodialysis associated hypotension.

关 键 词：透析性低血压 危险因素 分析 

分 类 号：R459.5[医药卫生—治疗学]