维持性血液透析低血压相关危险因素分析  

Analysis of intradialytic hypotension and related factors in patients with chronic renal failure

作　　者：郑强[1] 尉冬英[1] 夏映萍[1] 李雪梅[1] 蒋晗[1] 

机构地区：[1]成都市第六人民医院肾内科,四川成都610051

出　　处：《西部医学》2010年第2期228-230,共3页Medical Journal of West China

摘　　要：目的了解维持性血液透析患者低血压发生特点及规律，并分析其相关危险因素，以利于早期预防及治疗。方法将维持性血透患者58例随机分为透析低血压组和非低血压组，比较两组年龄、透龄、合并糖尿病及心脏损害等情况。结果相关分析显示：透析性低血压与年龄（r=0．223，P〈O．05）、超滤量（r=0．378，P〈0．05）、合并糖尿病（r=0．363，P〈0．05）、左心室肥厚程度（r=0．357，P〈0．05）呈显著正相关。低血压组与非低血压组相比，两组间性别构成、透龄、体重增长率、血红蛋白、透前肌酐无明显差异（P〉0．05）。透析2小时内的低血压发生率为5．71％，占总发生次数84．48％，与透析3～4小时相比具有显著统计学差异（P〈0．05）。结论血压降低的发生时间多为透析2个小时内，其中老年、合并糖尿病、合并心脏损害患者血压降低发生率明显增加。Objective To analyze the clinical characteristics and related factors of intradialytic hypotension （IDH） occurred in patients who undergoing maintenance hemodialysis. Methods 58 patients were divided into two groups. One was hypotension group and the other was non-hypotension group. We retrospectively analysis age, years of hemodialysis, complications of diabetic mellitus and cardiovascular disease. Results Correlation analysis shows that IDH correlate with age （r=0. 223,P〈0. 05）, quantity of ultrafiltration （r=0. 378,P〈0. 05）, complications of diabetic mellitus （r=0. 363, P〈0.05） and cardiovascular disease （r=0. 357,P〈0.05）. There was no significant differences of sex, years of hemodialysis, growth rate of weight, hemoglobin and serum creatinine between the tow groups. The morbidity of IDH in the first 2 hours of hemodialysis was 5.71% （account for 84.48% of all）, which was significant differences from that of the last 2 hours. Conclusion IDH usually happened in the first 2 hours during hemodialysis. The high frequencies of IDH was observed in old aged patients and patients with diabetic mellitus or with cardiovascular disease.

关 键 词：慢性肾功能衰竭 维持性血液透析 低血压 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学] R459.5[医药卫生—外科学]