血液透析患者单纯性结膜下出血相关影响因素研究  

Relationship between spontaneous subconjunctival hemorrhage and arterial stiffness in hemodialysis patients

作　　者：郑元培 傅胜惠[2] 高姗[2] 闫铁昆[2] 赵少贞[1] 

机构地区：[1]天津医科大学眼科医院屈光与角膜病科,天津300384 [2]天津医科大学总医院肾内科,天津300052

出　　处：《天津医科大学学报》2016年第2期157-159,共3页Journal of Tianjin Medical University

摘　　要：目的:探讨尿毒症血液透析患者单纯性结膜下出血相关影响因素。方法:观察310例行维持性血液透析治疗的尿毒症患者,根据观察期内是否新发单纯性结膜下出血,分为出血组与未出血组。记录患者临床资料及血生化检查指标。两组均行踝臂脉搏波传导速度(baPWV)检测。分析各组间临床及生化指标、baPWV的差异,探讨影响单纯性结膜下出血的危险因素。结果:310例尿毒症血液透析患者中,观察期内新发单纯性结膜下出血30例次。出血组患者透析龄、血压、既往单纯性结膜下出血病史、血磷、iPTH水平均明显高于未出血组,差异有统计学意义(均P<0.05),但肝素用量、血肌酐、TC、TG、CRP水平无明显差异(均P>0.05)。baPWV检测结果显示,出血组患者baPWV为(20.4±3.1)m/s,明显大于未出血组(14.2±3.6)m/s,差异有统计学意义(P<0.01)。多因素回归分析显示,既往单纯性结膜下出血病史、血压、baPWV水平是新发单纯性结膜下出血的独立危险因素。结论:单纯性结膜下出血病史、血压、baPWV可能是导致尿毒症血液透析患者单纯性结膜下出血的重要原因。Objective： To investigate the relationship between spontaneous subcoujunctival hemorrhage and arterial stiffness in uremic patients under maintained hemodialysis. Methods：Three hundred and ten maintained hemodialysis patients from January 2013 to December 2013 were involved and divided into hemorrhage group and non-hemorrhage group based on whether spontaneous sub-conjunctival hemorrhage occurred in the period. Clinical data and blood biochemical indexes were collected. Twenty healthy people served as the control group. The ankle-brachial pulse wave velocity（baPWV） was measured in all subjects. Results：There were 310 cases being enrolled in at the beginning and 30 cases with spontaneous subconjunctival hemorrhage in the observation period. The age, dialysis history,diabetes, hypertension, previous history of subconjunctival hemorrhage, serum phosphorus and iPTH were significantly higher in hemorrhage group than in non- hemorrhage group（all P〈0.05）. However, the doses of unfractionated heparin, serum creatinine, TC, TG,and CRP were not significantly different between the two groups（all P〈0.05）. The values of baPWV in hemorrhage group was（20.4 ± 3.1）m/s, significantly higher than in non-hemorrhage group[（14.2 ± 3.6） m/s] and in the control group [（11.2±2.2） m/s]（ all P〈0.01）. Multivariate regression analysis showed that the previous history of subconjunctival hemorrhage, hypertension, diabetes and baPWV were independent risk factors for spontaneous subconjunctival hemorrhage. Conclusion：The history of spontaneous subconjunctival hemorrhage, blood pressure, and baPWV may be important causes of spontaneous subconjunctival hemorrhage in patients under hemodialysis.

关 键 词：尿毒症 血液透析 动脉僵硬度 单纯性结膜下出血 高血压 

分 类 号：R777.39[医药卫生—眼科]