The analysis of relative factors of poor controll of blood pressure of maintenance hemodialysis patients
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摘要: 目的 分析研究维持性血液透析(MHD)患者血压控制不良的相关因素,明确该类患者血压控制不良的重要原因,为将来临床工作开展提供依据。 方法 选取2010年3月—2015年2月在肾内科进行维持性血液透析的患者160例,根据血压控制情况分为实验组、对照组,对照组39例,实验组121例,对照组为血压控制良好的患者,实验组为血压控制不良的患者,回顾分析2组患者本研究时间段内治疗后对相关指标的影响。对血液透析时间、透析之前和以后的体质量变化率、干体质量的达标情况、促红细胞生成素的应用量、残肾肾小球滤过率和有无定期采取血液透析进行单因素分析和采取多因素Logistic回归分析。 结果 通过单因素分析发现,甲状旁腺素(PTH)、促进红细胞生成素的应用量、干体质量的达标情况、血液透析之前和以后的体质量变化率、有无定期采取血液透析治疗以及残肾肾小球过滤率等指标,实验组与对照组之间的差异具有统计学意义(P<0.05);多因素的Logistic回归分析显示,干体质量的达标情况以及有无定期采取血液透析治疗具有统计学意义(P<0.05)。 结论 干体质量的达标情况以及有无定期采取血液透析治疗是维持性血液透析病人血压控制不良的主要危险因素,对维持性血液透析患者要正确评估病人的干体质量,确保定期透析,同时采用多种方式控制血压。Abstract: Objective To analyze the relative factors for poor blood pressure control in patients with maintenance hemodialysis (MHD), investigate the main causing such result and provide evidence for the future clinical settings. Methods Total 160 MHD patients between Mar.2010 and Feb.2015 in our department were enrolled and divided into study group (n=121) with poor blood pressure control and controlled group (n=39) with good blood pressure control. The clinical data of them were reviewed.The univariate analysis and multiple Logistic Regression analysis were performed for HD duration, body composition changes before and after HD, dry weight assessment, amount of EPO,glomerular filtration rate of the remnant kidney and irregular hemodialysis. Results The univariate analysis showed that there was statistical significance in the PTH level, amount of EPO,dry weight assessment, body composition changes before and after HD,glomerular filtration rate of the remnant kidney and irregular hemodialysis between the two groups (P<0.05).The multiple Logistic Regression analysis revealed that there was statistical significance in dry weight assessment and irregular hemodialysis(P<0.05). Conclusion The main dangerous factors for poor blood pressure control in patients with maintenance hemodialysis(MHD) are dry weight not up to standard and irregular hemodialysis.The valid assessment of dry weight,regular HD and effective management of blood press in the treatment will be helpful for MHD.
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Key words:
- Maintenance hemodialysis /
- Blood pressure management /
- Negative factors
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