维持性腹膜透析患者血压变异性的相关影响因素

徐光; 陶雅非; 鲁冰; 石新慧; 陶娇; 任东升

doi:10.3969/j.issn.1671-2390.2023.11.006

维持性腹膜透析患者血压变异性的相关影响因素

Factors associated with blood pressure variability in patients on maintenance peritoneal dialysis

摘要

摘要:
目的本研究旨在探究维持性腹膜透析人群中血压变异性的相关影响因素。
方法选择2019年6月至2020年6月在南阳市中心医院腹膜透析中心规律且随访透析时间大于3个月的142例腹膜透析患者。收集入院腹膜透析评估时的一周晨起收缩压以及其他临床资料。一周收缩压变异性的相关影响因素分析用多重线性回归分析。
结果共142例维持性腹膜透析患者纳入本研究，平均一周收缩压变异系数为（12.56 ± 2.90）%。透析龄每增加1个月，一周收缩压变异性增高0.12%（P = 0.01）。血红蛋白每增加1 g/L，收缩压变异性降低0.11%（P = 0.01）；每日出液量（尿量+超滤量）每增加100 mL/d，一周收缩压变异性约降低1%（P = 0.03）；含CCB类降压药物与血压变异性呈负相关（P = 0.04）。而年龄、性别、血白蛋白、血钙、血磷、甲状旁腺激素、腹膜性质、透析充分性（Kt/V值）、磷结合剂、人促红细胞生成素应用等与一周收缩压变异性无明显相关（P＞0.05）。
结论维持性腹膜透析人群一周收缩压变异性可能与透析龄呈正相关，而与血红蛋白、每日出液量、含CCB类降压药物呈负相关。

Abstract:
Objective To explore the related factors of weekly blood pressure variability (BPV) on maintenance peritoneal dialysis (MPD).
Methods A total of 142 patients on MPD for at least 3 months were recruited. Blood pressure was assessed weekly by variation coefficient (CV) of systolic blood pressure in morning. The relevant clinical data was collected. The association of BPV and predictors were estimated by a mixed-effect linear model.
Results Longer dialysis vintage was associated with elevated weekly BPV (P<0.05). The higher hemoglobin concentration, the greater daily fluid removal. And dosing of calcium antagonists was associated with attenuated weekly BPV (P<0.05). However, other factors (age, gender, albumin, serum calcium, serum phosphorus, parathyroid hormone, peritoneal transport features, dialysis adequacy, phosphate binders & erythropoietin) were not (P>0.05).
Conclusions Weekly BPV may be affected by dialysis vintage, hemoglobin concentration, daily fluid removal and dosing of calcium antagonists.

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