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目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者透析所致血压异常的相关因素。方法选择2012年10月—2014年6月收治的125例MHD患者作为研究对象。根据患者血压监测情况分为A组70例和B组55例。观察对比两组患者年龄、性别、体质指数、透析龄、干体重达标情况、KT/V值、透析次数、促红细胞生成素用药剂量、遵循医嘱使用降压药物情况等一般资料。计量资料采用t检验,计数资料采用χ2检验,对单因素分析后存在显著性差异的指标行非条件Logistic回归分析,P<0.05为差异有统计学意义。结果 KT/V值<1.2(OR=4.196,95%CI为1.761~9.546)、体重≥干体重的10%(OR=3.442,95%CI为1.486~7.268)、透析次数<2次/周(OR=4.295,95%CI为1.834~10.634)及未遵循医嘱使用降压药物(OR=3.953,95%CI为1.635~8.681)是影响MHD患者出现血压异常症状的独立危险因素。结论 KT/V值<1.2、体重≥干体重的10%、透析次数<2次/周、未遵循医嘱使用降压药物等为MHD患者出现透析致血压异常的独立危险因素,应当引起临床的广泛关注。
Objective To investigate the related factors of abnormal blood pressure caused by dialysis in patients with maintenance hemodialysis (MHD). Methods 125 patients with MHD admitted from October 2012 to June 2014 were enrolled in this study. According to patients with blood pressure monitoring were divided into group A 70 cases and group B 55 cases. Observe and compare two groups of patients, such as age, sex, body mass index, dialysis age, dry weight compliance, KT / V value, dialysis times, erythropoietin dosage, follow the doctor’s advice about the use of antihypertensive drugs and other general information. Measurement data using t test, count data using the χ2 test, univariate analysis showed significant differences after the index line conditional Logistic regression analysis, P <0.05 for the difference was statistically significant. Results KT / V values were less than 1.2 (OR = 4.196, 95% CI 1.761-9.546), body weight was 10% of dry weight (OR = 3.442, 95% CI 1.486-7.268) (OR = 3.953, 95% CI: 1.635-8.681) were independent risk factors for abnormal blood pressure in patients with MHD. OR = 4.295, 95% CI: 1.834-10.634) Conclusions KT / V value <1.2, body weight ≥ 10% of dry weight and number of dialysis <2 times / week. It is an independent risk factor for abnormal blood pressure caused by dialysis in patients with MHD who did not follow the prescriptions of antihypertensive drugs, which should lead to widespread clinical attention.