维持性血液透析患者脑梗死的相关因素分析  

An analysis of the related factors of cerebral infarction among maintenance hemodialysis patients

作　　者：胡永玮[1] 闵群燕[1] 邵敏[1] HU Yongwei;MIN Qunyan;SHAO Min(Hemodialysis Center,the First People's Hospital of Taicang,Jiangsu,Taicang 215400,China)

机构地区：[1]江苏省太仓市第一人民医院血透中心,江苏太仓215400

出　　处：《中国医药科学》2020年第21期219-222,共4页China Medicine And Pharmacy

摘　　要：目的探讨影响维持性血液透析患者脑梗死的相关因素。方法将2011年1月~2019年1月太仓市第一人民医院血液净化中心维持性血液透析患者233例分为两组,脑梗死组(22例)和非脑梗死组(211例),收集患者临床资料,使用Logistics回归模型探讨维持性血透患者发生脑梗死的独立危险因素。结果(1)维持性血液透析患者中,脑梗死的发生率为9.4%,脑梗死组的年龄(y)[(57.9±11.1)vs.(48.7±17.2)]、NT-proBNP(pg/mL)[19894(14501,28760)vs.8157(3874,12782)]、糖尿病发病率(36.3%vs.15.1%),透析前后的收缩压差[(65.0±23.1)vs.(49.3±27.5)mm Hg],透析前后的舒张压差[(35.2±10.3)vs.(24.3±11.1)mm Hg]均高于非脑梗死组,差异有统计学意义(P<0.05)。(2)Logistics回归结果提示,年龄(OR=1.042,95%CI=1.007~1.077,P=0.017)、糖尿病(OR=2.234,95%CI=1.164~23.537,P=0.036)、透析前后的收缩压差(OR=1.031,95%CI=1.009~1.061,P=0.043)、NT-proBNP(OR=2.672,95%CI=0.903~7.906,P=0.031)均与脑梗死的发生密切相关。结论维持性血液透析患者脑梗死发生率高,年龄、糖尿病、透析前后的收缩压差、NT-proBNP均是脑梗死发生的独立危险因素。Objective To explore the related factors of cerebral infarction(CI)among maintenance hemodialysis(MHD)patients.Methods 233 MHD patients treated in the blood purification center of the First People's Hospital of Taicang from January 2011 to January 2019 were divided into two groups,the CI group with 22 patients,the non CI group with 211 patients.The clinical data of the patients were collected,and Logistics regression model was used to explore the independent risk factors of CI among MHD patients.Results(1)The incidence of CI among MHD patients was 9.4%.The age(y)([57.9±11.1]vs.[48.7±17.2]),NT-proBNP(pg/mL)[19894(14501,28760)vs.8157(3874,12782)],incidence of diabetes mellitus(DM)(36.3%vs.15.1%),systolic blood pressure(SBP)gradient before and after dialysis([65.0±23.1]vs.[49.3±27.5]mm Hg)and diastolic blood pressure(DBP)gradient before and after dialysis([35.2±10.3]vs.[24.3±11.1]mm Hg)of the CI group were all higher than those of the non CI group,and the differences between the two groups were statistically significant(P<0.05).(2)According to the results of Logistics regression,the age(OR=1.042,95%CI=1.007-1.077,P=0.017),DM(OR=2.234,95%CI=1.164-23.537,P=0.036),SBP gradient before and after dialysis(OR=1.031,95%CI=1.009-1.061,P=0.043)and NT-proBNP(OR=2.672,95%CI=0.903-7.906,P=0.031)were all closely related to the occurrence of CI.Conclusion The incidence of CI is high among MHD patients.Age,DM,SBP gradient before and after dialysis and NT-proBNP are all independent risk factors of CI.

关 键 词：血液透析 脑梗死 收缩压 N末端B型脑利钠肽 

分 类 号：R459.5[医药卫生—治疗学] R743.3[医药卫生—临床医学]