目的 研究维持性血液透析过程中患者血压变异性(BPV)及影响BPV增加的因素.方法 选择126例维持性血液透析患者,分别为低收缩压变异性组(LS-BPV组)63例和高收缩压变异性组(HS-BPV组)63例,低舒张压变异性组(LD-BPV组)63例和高舒张压变异性组(HD-BPV组)63例.结果 HS-BPV组和LS-BPV组年龄、透析龄、干体重、体质量指数、透析期间体重增长率、透析前SBP、白蛋白、血红蛋白、总胆固醇、钙磷乘积有显著差异(P<0.05).HD-BPV组和LD-BPV组年龄、干体重、体质量指数、透析间期体重增率、透析前SBP、透析前DBP、血红蛋白、钙磷乘积有显著差异(P<0.05).年龄、透析期间体重增长率、透析前SBP是收缩压BPV独立影响因素并呈正相关(P<0.05),血红蛋白是收缩压BPV独立影响因素并呈负相关性(P<0.05).透析间期体重增率、透析前DBP是舒张压BPV独立影响因素并呈正相关性(P<0.05).结论 高龄、透析期间体重增长率增加、透析前高SBP、血红蛋白降低是维持性血液透析过程中患者收缩压BPV增加的独立危险因素;透析期间体重增长率增加、透析前高DBP是维持性血液透析过程中舒张压BPV增加的独立危险因素.
Objective To study blood pressure variability (BPV) and risk factors of BPV increasing for patients in the process of maintenance hemodialysis. Methods A total of 126 cases of hemodialysis patients, were divided LS-BPV group of 63 cases, and HS-BPV group of 63 cases, LD-BPV group of 63 cases, and HD-BPV group of 63 cases. Resuits HS-BPV group and the LS-BPV group age, duration of dialysis, dry weight , body mass index, weight increased during dialysis, pre-dialysis SBP, albumin , hemoglobin , total cholesterol, calcium-phosphorus product were statistically significance difference(P〈0.05). HD-BPV group and LD-BpV group age, dry weight, body mass index, dialysis room rate of weight gain, pre-dialysis SBP, pre-dialysis DBP, hemoglobin, calcium-phosphorus product were statistically significance differences (P〈O.05). Weight increased age, during dialysis, pre-dialysis systolic BPV SBP were independent factors and a posi tire correlation (P〈0.05), systolic BPV hemoglobin was an independent factor and a negative correlation (P〈0.05). The rate of weight gain between dialysis , pre-dialysis DBP were diastolic BPV and independent factors were positively correlated (P〈0.05). Conclusion Age, weight growth increased during dialysis, dialysis before the high SBP, hemoglobin reduction are the process of maintenance hemodialysis patients with increased systolic BPV independent risk factor ; weight growth rate increased during dialysis , pre-dialysis DBP is to maintain a high blood BPV independent risk factor for the increase in diastolic blood pressure during dialysis.