维持性血液透析患者血压控制不良影响因素分析

摘要

目的 探讨维持性血液透析(MHD)患者血压控制不良的影响因素.方法 回顾性分析160例MHD患者临床资料,根据血压控制情况分为两组,对比两组性别、年龄、体重指数(BMT)、残肾肾小球滤过率(GFR)、血红蛋白(Hb)、血白蛋白、甲状旁腺素(PTH)、透析时间、体质量变化率、Kt/V以及是否能够定期透析治疗等方面的差异,对具有显著性差异的因素进行Logistic回归分析.结果 两组患者在BMI、残肾GFR、PTH、透析时间、体质量变化率、Kt/V以及是否定期透析治疗方面差异有统计学意义(P＜0.05或P＜0.01)；多因素Logistic回归分析显示,透析时间长、体质量增加、Kt/V低(透析不充分)、未定期透析是MHD患者血压控制不良的独立危险因素(P＜0.05).结论 MHD患者血压控制不良相关因素较多,应掌握其危险因素进行有针对性的临床控制.%Objective To discuss the influencing factors of poor-controlled hypertension in maintenance hemodialysis patients. Methods The clinical data of 160 maintenance hemodialysis patients were analyzed retrospectively, and all patients were divided into two groups according to the blood pressure control results. Then gender, age, BMI, GFR, Hb, albumin, PTH, dialysis time, body quality rate, Kt/V and whether regular dialysis or not were contrasted between the two groups. Logistic regression analysis was adopted among factors which had significant differeces. Results There were significant differences in BMI, GFR, PTH, dialysis time, body quality rate, Kt/V and whether regular dialysis between the two groups (P < 0.05 or P < 0.01). Long dialysis time, body quality increase, low Kt/V, non-regular dialysis were independence risk factors of poor-controlled hypertension in maintenance hemodialysis patients, according to the Logistic regression analysis. Conclusion There are many factors related to poor-controlled hypertension in maintenance hemodialysis patients, the risk factors should be mastered, in order to proceed pertinent clinical control.