血液透析充分性的影响因素分析

    Analysis on influencing factors of hemodialysis adequacy in maintenance hemodialysis patients

      摘要
    • 摘要: 目的 探讨维持性血液透析（maintenance hemodialysis，MHD）患者单次血液透析充分性的影响因素。方法 选取2019年3月在航空总医院血液净化中心行规律血液透析的109例患者，观察记录患者的临床资料，包括性别、年龄、体质量指数、原发病、血管通路及单次血液透析中患者的透析前后尿素氮、透析时间、超滤量、血流量、干体质量和超滤率等。根据单室尿素清除率（single-pool Kt/V，spKt/V）结果分为达标组（spKt/V≥1.2）与未达标组（spKt/V<1.2），分析探讨MHD患者单次血液透析充分性与临床数据的关系。结果 单因素分析显示性别、透析相关性凝血、泵控血流量、动静脉内瘘、干体质量共5个因素与spKt/V相关（P<0.05），二元Logistic回归分析显示性别（OR=4.345，95%CI 1.240~15.070，P<0.05）、透析相关性凝血（OR=5.497，95%CI 1.213~27.125，P<0.05）、动静脉内瘘作为血管通路（OR=0.105，95%CI 0.012~0.889，P<0.05）和泵控血流量（OR=0.984，95%CI 0.969~0.998，P<0.05）是单次血液透析spKt/V的独立影响因素。结论 MHD患者单次血液透析充分性与患者性别、透析相关性凝血、泵控血流量及使用动静脉内瘘作为血管通路密切相关。

       

      Abstract: Objective To explore the influencing factors of adequacy of single hemodialysis in maintenance hemodialysis (MHD) patients.Methods A total of 109 patients who underwent MHD in Blood Purification Centre of Aviation General Hospital in March 2019 were enrolled in this study.The data on pre-HD and post-HD gender,age,body mass index (BMI),primary disease,vascular access and blood urea nitrogen (BUN),hemodialysis time,ultrafiltration volume (UF),blood flow rate (BFR),dry body weight and ratio of UF in single hemodialysis were recorded.According to spKt/v results,the patients were divided into two groups:qualification group (spKt/V ≥ 1.2) and disqualification group (spKt/v<1.2).The influencing factors were analyzed.Results Univariate analysis showed that spKt/V was correlated with gender,dialysis associated coagulation,BFR,arteriovenous fistula (AVF)and dry body weight (P<0.05).Binary Logistic regression showed that gender (OR=4.345,95%CI 1.240~15.070,P<0.05),dialysis associated coagulation (OR=5.497,95%CI 1.213~27.125,P<0.05),BFR(OR=0.984,95%CI 0.969~0.998,P<0.05) and AVF as vascular access (OR=0.105,95%CI 0.012~0.889,P<0.05) were independent influencing factors of spKt/V for single hemodialysis.Conclusions The single hemodialysis adequacy in MHD patients is closely associated to gender,dialysis associated coagulation,BFR and AVF.

       

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