维持性血液透析患者合并透析相关低血压的危险因素  

Risk factors for dialysis-related hypotension in maintenance hemodialysis patients

作　　者：李鹏举 刘凤菊 Li Pengju;Liu Fengju(Department of Hemodialysis,People’s Hospital of Zhalainuoer District,Hulunbuir 021410,Chinn)

机构地区：[1]呼伦贝尔市扎赉诺尔区人民医院血液透析科,021410

出　　处：《国际移植与血液净化杂志》2022年第5期9-12,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者发生透析相关低血压(intradialytic hypotension,IDH)的危险因素,为防治提供依据。方法选取2021年5月至2022年5月间呼伦贝尔市扎赉诺尔区人民医院血液净化科收治的69例MHD患者为研究对象,根据有无透析相关低血压发生将患者分为IDH组(26例)和无IDH组(43例),比较IDH组和无IDH组患者的临床资料和实验室指标。采用多因素Logistic回归分析MHD患者并发IDH的危险因素。结果MHD患者IDH的发生率为37.68%。IDH组年龄显著高于非IDH组(P<0.05),血红蛋白、肌酐、白蛋白、血清钠离子显著低于非IDH组(P<0.05)。Logistic回归分析结果显示,血清钠离子低[比值比(OR)=1.185,95%可信区间(CI)1.008~1.349,P=0.039]及透析前肌酐低(OR=1.003,95%CI 1.001~1.006,P=0.005)是MHD患者并发IDH的危险因素。结论MHD并发IDH患者的临床特点包括高龄、贫血以及营养不良等。血清钠离子及透析前肌酐水平是影响MHD患者发生IDH的独立危险因素。Objective To investigate the risk factors of intradialytic hypotension(IDH)in maintenance hemodialysis(MHD)patients,and to provide evidence for prevention and treatment.Methods From May 2021 to May 2022,69 MHD subjects in the Blood Purification Department of Zhalainuoer District People’s Hospital,Hulunbuir were selected.According to the presence or absence of dialysis-related hypotension,the patients were divided into IDH group(26 cases)and IDH-free group(43 cases).The clinical data and laboratory parameters were compared between the IDH group and the non-IDH group.Multivariate Logistic regression was used to analyze the risk factors of MHD patients complicated with IDH.Results The incidence of IDH in MHD patients was 37.68%.The age of IDH group was significantly higher than that of non-IDH group(P<0.05).The hemoglobin,creatinine,albumin,and serum sodium ion of IDH group were significantly lower than those of non-IDH group(P<0.05).Logistic regression analysis showed that low serum sodium(OR=1.185,95%CI 1.008-1.349,P=0.039)and low creatinine before dialysis(OR=1.003,95%CI 1.001-1.006,P=0.005)were MHD patients Risk factors for concurrent IDH.Conclusion The clinical features of IDH in MHD patients often include advanced age,anemia and malnutrition.Serum sodium and predialysis creatinine levels were independent risk factors for IDH in maintenance hemodialysis patients.

关 键 词：透析相关低血压 血液透析 危险因素 预后 

分 类 号：R692.5[医药卫生—泌尿科学]