中文摘要：

目的探讨糖尿病肾病（DKD）所致终末期肾病（ESRD）行维持性血液透析（MHD）患者的高血压情况。方法收集上海市39家血液透析中心558例DKD所致ESRD行MHD患者的高血压相关临床和实验室检查资料，并进行统计学分析。结果558例患者中高血压患者共523例，患病率为93．7％。不同性别问高血压患病率、收缩压和舒张压的差异均无统计学意义（P值均〉0．05）。接受抗高血压药物治疗的患者共490例，应用药物治疗比例为93．7％（490／523），不同性别间高血压治疗率的差异均无统计学意义（P〉0．05）。使用的降压药物以钙通道阻滞剂（CCB）最多（366例，占74．7％），其次为血管紧张素受体阻滞剂（ARB，166例，占33．9％）和血管紧张素转换酶抑制剂（ACEI，95例，占19．4％）。应用1种药物以CCB最为常用，应用2种药物以CCB联合ARB最为常用。128例（24．5％）患者达到血压控制靶目标（≤140／90mmHg，1mmHg-0．133kPa），不同性别间血压控制率的差异无统计学意义（P〉o．05）。血压控制组的年龄显著大于血压未控制组（P〈O．05），尿素清除指数（KT／V）、尿素清除率（URR）、血红蛋白水平显著高于血压未控制组（P值均〈0．05），高血压用药种类显著少于血压未控制组（P〈o．05）。单因素Logistic分析发现，高血压用药种类为血压控制的危险因素（OR=1．34，95％CJ为1．07～1．69，P〈0．05），年龄（OR=0．96，95％CI为0．94～0．98，P〈0．05）和血红蛋白水平（OR=0．98，95％CI为0．97～0．99，P〈0．05）为血压控制的保护因素。逐步多因素Logistic回归分析发现，患者血压控制与年龄、高血压用药种类和血红蛋白水平显著相关，回归系数分别为-0．40、0．24、-0．02（P值均d0．05），年龄越小、高血压用药种类越多、血红蛋白水平越低，血压控制越不理想。结论DKD所致ESRD?

英文摘要：

Objective To investigate the prevalence and treatment of hypertension in maintenance hemodialysis （MHD） patients with end stage renal disease （ESRD） caused by diabetic kidney disease （DKD）. Methods A total of 558 MHD patients with ESRD caused by DKD were collected from 39 hemodialysis centers in Shanghai. The clinical and laboratory data were statistically analyzed. Results Hypertension was found in 523 patients, with a prevalence of 93.7%. There were no significant differences in the prevalence of hypertension, systolic or diastolic blood pressure between male and female hypertensive patients （P〈0.05）. There were 490 patients who were treated with antihypertensive drugs, and the treatment rate was 93. 7% （490/523）. No significant difference was found in the treatment rate between men and women （ P 〈 0. 05）. Calcium channelblocker （CCB） was the most frequently used （in 366 patients, 74.7% ）, followed by angiotensin receptor blockers （ARB, in 166 patients, 33.9 % ） and angiotensin converting enzyme inhibitors （AOEI, in 95 patients, 19.4% ）. COB was the most popular single drug. OCB and ARB were the most frequently chosen pair for combination drug therapy. The blood pressure control target （ 140/90 mmHg, 1 mmHg = 0. 133 kPa） was achieved in 128 patients （24.5%）. There was no significant difference in the control rate between males and females （ P〈0.05）. The age, urea removal index （KT/V）, urea removal rate （URR）, and hemoglobin level in the patients with controlled blood pressure were significantly higher than those in the patients without well controlled blood pressure （P〈0.05）. The kinds of antihypertensive drug used in the patients with controlled blood pressure were significantly less than that in the patients without well controlled blood pressure （P〈O. 05）. Single factor Logistic analysis showed that the kind of antihypertensive drug was the risk factor for blood pressure control （OR = 1.34, 95% CI 1.07 - 1.69, P〈 0.05）, while