血液透析充分性的影响因素分析  

Analysis on influencing factors of hemodialysis adequacy in maintenance hemodialysis patients

作　　者：高艳[1] 房艳辉 郜同心 郭学娜[1] 任建伟[1] GAO Yan;FANG Yan-hui;GAO Tong-xin;GUO Xue-na;REN Jian-wei(Department of Nephrology,Aviation General Hospital,China Medical University,Beijing 100012,China)

机构地区：[1]中国医科大学航空总医院肾内科,北京100012

出　　处：《临床肾脏病杂志》2020年第7期567-572,共6页Journal Of Clinical Nephrology

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者单次血液透析充分性的影响因素。方法选取2019年3月在航空总医院血液净化中心行规律血液透析的109例患者,观察记录患者的临床资料,包括性别、年龄、体质量指数、原发病、血管通路及单次血液透析中患者的透析前后尿素氮、透析时间、超滤量、血流量、干体质量和超滤率等。根据单室尿素清除率(single-pool Kt/V,spKt/V)结果分为达标组(spKt/V≥1.2)与未达标组(spKt/V<1.2),分析探讨MHD患者单次血液透析充分性与临床数据的关系。结果单因素分析显示性别、透析相关性凝血、泵控血流量、动静脉内瘘、干体质量共5个因素与spKt/V相关(P<0.05),二元Logistic回归分析显示性别(OR=4.345,95%CI 1.240~15.070,P<0.05)、透析相关性凝血(OR=5.497,95%CI 1.213~27.125,P<0.05)、动静脉内瘘作为血管通路(OR=0.105,95%CI 0.012~0.889,P<0.05)和泵控血流量(OR=0.984,95%CI 0.969~0.998,P<0.05)是单次血液透析spKt/V的独立影响因素。结论MHD患者单次血液透析充分性与患者性别、透析相关性凝血、泵控血流量及使用动静脉内瘘作为血管通路密切相关。Objective To explore the influencing factors of adequacy of single hemodialysis in maintenance hemodialysis(MHD)patients.Methods A total of 109 patients who underwent MHD in Blood Purification Centre of Aviation General Hospital in March 2019 were enrolled in this study.The data on pre-HD and post-HD gender,age,body mass index(BMI),primary disease,vascular access and blood urea nitrogen(BUN),hemodialysis time,ultrafiltration volume(UF),blood flow rate(BFR),dry body weight and ratio of UF in single hemodialysis were recorded.According to spKt/v results,the patients were divided into two groups:qualification group(spKt/V≥1.2)and disqualification group(spKt/v<1.2).The influencing factors were analyzed.Results Univariate analysis showed that spKt/V was correlated with gender,dialysis associated coagulation,BFR,arteriovenous fistula(AVF)and dry body weight(P<0.05).Binary Logistic regression showed that gender(OR=4.345,95%CI 1.240~15.070,P<0.05),dialysis associated coagulation(OR=5.497,95%CI 1.213~27.125,P<0.05),BFR(OR=0.984,95%CI 0.969~0.998,P<0.05)and AVF as vascular access(OR=0.105,95%CI 0.012~0.889,P<0.05)were independent influencing factors of spKt/V for single hemodialysis.Conclusions The single hemodialysis adequacy in MHD patients is closely associated to gender,dialysis associated coagulation,BFR and AVF.

关 键 词：维持性血液透析 透析充分性 影响因素 

分 类 号：R692.5[医药卫生—泌尿科学]