透析间期动态血压与透析日血压的相关性研究  

The correlation between interdialytic ambulatory blood pressure and intradialytic blood pressure

作　　者：李成 甘良英 杨冰[1] 赵新菊[1] 王磊[1] 蔡美顺[1] 左力[1] LI Cheng;GAN Liang-ying;YANG Bing;ZHAO Xin-jun;WANG Lei;CAI Mei-shun;ZUO Li(Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China;Department of Nephrology, Affiliated Hospital of Jiujiang University, Jiujiang 332000, China)

机构地区：[1]北京大学人民医院肾内科,北京100044 [2]九江学院附属医院肾内科,九江332000

出　　处：《中国血液净化》2019年第7期482-485,共4页Chinese Journal of Blood Purification

基　　金：北京市科学技术委员会首都临床特色应用研究支持项目(Z131107002213122)

摘　　要：目的明确维持性血液透析(maintenance hemodialysis,MHD)患者透析间期动态血压(ambulatory blood pressure monitoring,ABPM)的情况及其与透析日血压的相关性。方法选取2014 年12月~2017 年12 月在北京大学人民医院接受MHD 治疗患者51 例,分别采集患者透析间期44hABPM 值及该周3 个透析日透析前、透析中及透析结束后血压数值。采用配对样本t 检验比较透析间期与透析日血压,采用Pearson 相关性分析衡量透析间期ABPM 值和透析日各时段血压测量值之间的相关性,通过Blandaltman分析对这2 种测量方法进行一致性检验。结果透析间期ABPM 值与透析日血压值之间存在差异(t=-3.854,P<0.001)。透析间期收缩压与透析前、透析中及透析后收缩压之间存在较弱的相关性(r值分别为0.381,0.442,0.374;P 值分别为0.007,0.001,<0.001),其中以透析间期44h 收缩压与透析中收缩压的关系较为显著。Bland-altman 分析显示透析间期44h 收缩压与透析中收缩压差值的95% CI 为(-32.42,35.64)mmHg(1mmHg=0.1333kpa)。结论患者透析间期血压与透析日血压水平存在差异,透析日血压不能取代ABPM用于评估MHD 患者透析间期的血压水平。Objective To determine the situation of interdialytic ambulatory blood pressure monitoring (ABPM) and its correlation with intradialytic blood pressure (BP) in maintenance hemodialysis (MHD) patients. Methods Fifty-one MHD patients treated in Peking University People’s Hospital from Dec. 2014 to Dec. 2017 were recruited. Their interdialytic ABPM values for 44 hours and the BP values before, during and after dialysis for 3 sessions in this week were collected. Paired sample t test was used to compare interdialytic BP values and the BP values in the dialysis day. Pearson correlation analysis was used to evaluate the correlation between interdialytic ABPM values and BP values at different stages in the dialysis day. Bland-altman difference method was used to test the consistency of the two measurement methods. Results There was a difference between interdialytic ABPM values and the BP values in the dialysis day (t=- 3.854, P<0.001). There were weak correlations of interdialytic systolic BP (SBP) with the SBP before (r=0.381, P=0.007), during (r=0.442, P=0.001) and after dialysis (r=0.374, P<0.001) in the dialysis day, in which significant relationship was present between interdialytic 44 hours SBP and the SBP during dialysis. Bland-Altman analysis showed that the 95% confidence interval for the difference between interdialytic 44 hours SBP and the SBP during dialysis was -32.42, 35.64 mmHg. Conclusion Interdialytic BP was different from the BP in the dialysis day. BP in the dialysis day cannot replace ABPM for evaluating interdialytic BP in MHD patients.

关 键 词：动态血压 血液透析 透析日血压 

分 类 号：R459.5[医药卫生—治疗学]