超滤率对维持性血液透析患者透析中血压变异性的影响  

Impact of ultrafiltration rate on blood pressure variability in patients with maintenance hemodialysis

作　　者：崔冬梅 陈迎归 韩晓苇[3] 全梓林 宋利 赵立艳 钟咪 周丽芳 孙春艳 赵宜娜 史丽华 符霞 CUI Dongmei;CHEN Yinggui;HAN Xiaowei;QUAN Zilin;SONG Li;ZHAO Liyan;ZHONG Mi;ZHOU Lifang;SUN Chunyan;ZHAO Yi’na;SHI Lihua;FU Xia(Department of Nephrology,Guangdong Provincial People’s Hospital/Guangdong Academy of Medical Sciences,Guangzhou,Guangdong 510080,China;School of Nursing,Southern Medical University,Guangzhou,Guangdong 510515,China;Department of Nephrology,Shenzhen Municipal Hospital of Traditional Chinese Medicine,Shenzhen,Guangdong 518033,China;Faculty of Nursing,Medical College of Shantou University,Shantou,Gunagdong 515063,China;Department of Nursing,Eighth Affiliated Hospital of Sun-Yat-Sen University,Shenzhen,Guangdong 518033,China)

机构地区：[1]广东省人民医院/广东省医学科学院肾内科,广州510080 [2]南方医科大学护理学院,广州510515 [3]深圳市中医院肾内科,深圳518033 [4]汕头大学医学院护理系,汕头515063 [5]中山大学附属第八医院护理部,深圳518033

出　　处：《重庆医学》2022年第21期3650-3653,共4页Chongqing medicine

基　　金：登峰计划-院内护理科研基金项目(DFJH2021007,DFJH2021012)。

摘　　要：目的探讨超滤率对维持性血液透析(MHD)患者透析中血压变异性(BPV)的影响。方法选取2020年1-6月在广东省人民医院、深圳市中医院接受MHD患者278例,根据2020年6月患者每次透析实际超滤量、透析治疗时间和干体重,计算每次超滤率(UFR),根据每次UFR的平均值分为高超滤组(UFR>10 mL·h^(-1)·kg^(-1))196例和低超滤组(UFR≤10 mL·h^(-1)·kg^(-1))92例,比较2组患者透析中BPV的差异。BPV用多个血压读数的变异系数(CV)来表示。结果高超滤组和低超滤组患者透析中收缩压变异性系数(SBP CV)分别为10.57(8.59,12.44)和9.20(7.68,10.93),差异有统计学意义(P=0.001);多重线性回归分析显示,UFR是MHD患者透析中SBP CV的独立危险因素。结论将MHD患者的UFR控制在≤10 mL·h^(-1)·kg^(-1),可有效降低患者透析中的SBP CV,提高患者透析的耐受性。Objective To investigate the impact of ultrafiltration rate on intradialytic blood pressure variability(BPV)in the patients with maintenance hemodialysis(MHD).Methods A total of 278 patients with MHD in Guangdong Provincial People’s Hospital and Shenzhen Municipal Hospital of Traditional Chinese Medicine from January to June 2020 were selected.The ultrafiltration rate(UFR)was calculated by using the actual ultrafiltration volume,dialysis treatment time and dry weight of each dialysis in June 2020.According to the average value of each UFR,they were divided into the high ultrafiltration group(UFR>10 mL·h^(-1)·kg^(-1),196 cases)and the low ultrafiltration group(UFR≤10 mL·h^(-1)·kg^(-1),92 cases).The difference of intradialytic BPV was compared between the two groups.BPV was represented by coefficient of variation(CV)of multiple blood pressure readings.Results The systolic blood pressure variability(SBP CV)in the high ultrafiltration group and the low ultrafiltration group were 10.57(8.59,12.44)and 9.20(7.68,10.93)respectively,and the difference was statistically significant(P=0.001).The multiple linear regression analysis showed that UFR was an independen t risk factor for SBP CV in MHD patients.Conclusion Controlling UFR of MHD patients at≤10 mL·h^(-1)·kg^(-1) could effectively reduce the BPV CV clueing dialysis and improve the dialysis tolerance of the patients.

关 键 词：血液透析 超滤率 血压变异性 收缩压 舒张压 

分 类 号：R692.5[医药卫生—泌尿科学]