老年维持性血液透析患者血管钙化与透析间低血压的相关性研究

摘要

Objective To investigate the correlation of vascular calcification (VC)with intradialytic hypotension (IDH)and to evaluate the effect of VC on IDH in elderly patients undergoing maintenance hemodialysis(MHD). Methods This retrospective study selected 403 elderly patients aged 65-85 years(216 males and 187 females)who underwent hemodialysis 3 times a week,4 hours per session for more than 6 months and less than 10 years from the Department of Blood Purification,General Hospital of Shenyang Military Area Command. All patients demonstrated stable conditions with no acute cardiovascular events. VC was determined by chest X-ray examination. IDH was defined when systolic blood pressure was below 90 mmHg or there was a need for reinfusion of saline or glucose solution. Results VC was found in 52 MHD patients (12.9%of the total number). IDH was more prevalent in patients with VC than in those without VC (34.6% vs 18.5%,P=0.005). VC was an independent risk factor for IDH. Conclusion VC is closely related to IDH,and a proper control of VC may improve the prevention of IDH in elderly MHD patients.%目的 探讨老年维持性血液透析(maintenance hemodialysis,MHD)患者血管钙化(vascular calcification,VC)和透析间低血压(intradialytic hypotension,IDH)的相关性,评估血管钙化对老年MHD患者合并透析间低血压的影响.方法 回顾性选取沈阳军区总医院血液净化科403例老年患者,其中男性216例,女性187例.入选标准为:血液透析3次/周,每次4 h;年龄65~85岁;透析时限6个月~10年;病情稳定,无急性心血管事件.血管钙化可由胸部正位片检查判断,透析间低血压定义为收缩压<90 mmHg或需要回输生理盐水或葡萄糖溶液.结果 血管钙化的MHD患者52名(12.9%),IDH在血管钙化患者中发生率较无血管钙化高(34.6%v s 18.5%,P=0.005),血管钙化是透析间低血压发生的风险的独立影响因素.结论 血管钙化与透析间低血压密切相关,良好的控制血管钙化进程可能对于防止透析间低血压的发生具有一定的意义.