维持性血透患者透析低血压相关因素的分析.docVIP

精品论文 参考文献 维持性血透患者透析低血压相关因素的分析 酉丽红 付隆君 王爱华 冉雪梅 袁红梅 　　攀枝花市攀钢集团总医院肾内科 四川攀枝花 617023 　　摘要：目的 探讨维持性血液透析（maintenance hemodialysis MHD）患者透析低血压（intradialytic-hypotension IDH）相关影响因素，为临床提供防治依据。方法 收集2014年1月~2014年12月在攀钢集团总医院肾内科血液净化中心100例MHD患者资料，根据6个月内每次透析血压情况，分成透析低血压（IDH）组和无透析低血压组（N0-IDH）组，用单因素分析方法比较两组患者年龄、性别、透析龄、原发病、超滤量、超滤率、相对超滤量、透析液温度、钠浓度等资料的差异，多因素筛选出透析低血压的危险因素。结果 100例患者入组，其中男71人，女29人，年龄25~86（56.48plusmn;13.91）岁。低血压组43例，男32例，女11例，年龄39~78（64.69plusmn;10.03）岁；非低血压组57例，男，39例，女18例，年龄25~86（50.26plusmn;13.23）岁，共透析5741次，低血压发生2268次，发生率为39.5%。两组患者透析相关资料的比较发现年龄、合并糖尿病、超滤量、超滤率、相对超滤量、葡萄糖下降值在透析低血压组均高于非低血压组，差异具有统计学意义（P＜0.05）；多因素logistic回归分析发现年龄、合并糖尿病、超滤率高、相对超滤量大与透析低血压相关（P＜0.05），其中高龄和合并糖尿病与透析低血压的相关性较高（or 值为2.003和1.973，P值均＜0.000）。结论 年龄、合并糖尿病、高超滤率、相对超滤量大与透析低血压密切相关。 　　关键词：透析低血压；相关因素；分析 　　【Abstract】Objective To discuss the related factors for intradialytic hypotension（IDH）among maintenace hemodialytic patients and to provide the useful information for the preventions and treatment of IDH.Methods According to the diagnostic standard of hemodialysis associated hypotension，100 patients，blood pressure of which was monitored in a 6-month period during Jan.2014-Dec.2014，were divided into two groups：IDH group and No-IDH group.Age，gender，age of dialysis，ultrafiltration volume，ultrafiltration rate，relative ultrafiltration，dialysis fluid data such as temperature，concentration of sodium were compared with Single factor analysis，then multiple factors analysis was used to assess the significant factors.Results A total of 100 patients were recruited.Male 71%，with an age range 25~86.The incidence rate of IDH was 39.5%。Single factor analysis showed that age，diabetic nephropathy，ultrafiltration volume，ultrafiltration rate，relative ultrafiltration， desent volume of blood glucose were associated with IDH；Multivariate logistic regression showed that age，diabetic nephropathy，high ultrafiltration rate，high relative ultrafiltration were the risks of IDH.Conclusion age，diabetic nephropathy，high ultrafiltratio