维持性血液透析患者透析中低血压的发生情况及原因分析

摘要

目的：观察维持性血液透析（maintenance hemodialysis, MHD）患者透析中低血压（intradialytic hypotension, IDH）的发生情况和原因，为预防、治疗提供依据。方法收集2014年2月～2014年5月MHD治疗患者87例，连续30次血液透析过程中血压下降情况，分为低血压组和无低血压组，回顾分析各个指标与透析中低血压发生的相关性。结果血液透析过程中低血压发生共30例（34.5%），低血压组患者的年龄、透析龄、超滤量、血N末端B型利钠肽原（NT-proBNP）水平显著高于无低血压组（P＜0.05）。而低血压组患者的血浆白蛋白水平显著低于无低血压组（P＜0.05）。低血压组糖尿病肾病比例显著高于无低血压组（P＜0.05）。结论高龄、高超滤量、低血浆白蛋白、血NT-proBNP升高，均为引起透析中低血压的原因。%Objective To observe the incidence of intradialytic hypotension and reasons of maintenance hemodialysis patients, and to provide evidence for the prevention and treatment.Methods 87 patients with maintenance hemodialysis treatment with 30 consecutive decline of blood pressure during hemodialysis in our hospital from 2014 February to May were divided into non-hypotension group and intradialytic hypotension group for retrospective analysis of each index and the incidence of intradialytic hypotension.Results In the process of intradialytic, hypotension were 30 cases (34.5%). Age, dialysis ages, ultrafi ltration volume and serum NT-proBNP level in intradialytic hypotension group were signifi cantly higher than those in non-hypotension group (P<0.05). Serum albumin level in intradialytic hypotension group was signifi cantly lower than that in non-hypotension group (P<0.05). The proportion of diabetic nephropathy in intradialytic hypotension group was signifi cantly higher than that in non-hypotension group (P<0.05).Conclusion Elderly, higher ultrafi ltration volume, hypoalbuminemia, increased serum NT-proBNP are the causes of intradialytic hypotension.