论文部分内容阅读
目的分析研究维持性血液透析(MHD)患者血压控制不良的相关因素,明确该类患者血压控制不良的重要原因,为将来临床工作开展提供依据。方法选取2010年3月—2015年2月在肾内科进行维持性血液透析的患者160例,根据血压控制情况分为实验组、对照组,对照组39例,实验组121例,对照组为血压控制良好的患者,实验组为血压控制不良的患者,回顾分析2组患者本研究时间段内治疗后对相关指标的影响。对血液透析时间、透析之前和以后的体质量变化率、干体质量的达标情况、促红细胞生成素的应用量、残肾肾小球滤过率和有无定期采取血液透析进行单因素分析和采取多因素Logistic回归分析。结果通过单因素分析发现,甲状旁腺素(PTH)、促进红细胞生成素的应用量、干体质量的达标情况、血液透析之前和以后的体质量变化率、有无定期采取血液透析治疗以及残肾肾小球过滤率等指标,实验组与对照组之间的差异具有统计学意义(P<0.05);多因素的Logistic回归分析显示,干体质量的达标情况以及有无定期采取血液透析治疗具有统计学意义(P<0.05)。结论干体质量的达标情况以及有无定期采取血液透析治疗是维持性血液透析病人血压控制不良的主要危险因素,对维持性血液透析患者要正确评估病人的干体质量,确保定期透析,同时采用多种方式控制血压。
Objective To analyze the related factors of poor blood pressure control in maintenance hemodialysis (MHD) patients and to identify the important causes of poor blood pressure control in these patients and to provide basis for future clinical work. Methods 160 cases of patients undergoing maintenance hemodialysis in Department of Nephrology from March 2010 to February 2015 were divided into experimental group, control group and control group according to blood pressure control. Controlled patients, the experimental group of patients with poor blood pressure control, the two groups were analyzed retrospectively during the study period after treatment on the impact of relevant indicators. The hemodialysis time, before and after dialysis body mass change rate, dry weight standards, the application of erythropoietin, residual renal glomerular filtration rate and the presence of regular hemodialysis for univariate analysis and Multi-factor Logistic regression analysis. Results By univariate analysis, it was found that PTH, the application of erythropoietin, the compliance of dry weight, the rate of change of body mass before and after hemodialysis, the presence or absence of hemodialysis and residual Kidney glomerular filtration rate and other indicators, the experimental group and the control group, the difference was statistically significant (P <0.05); multivariate logistic regression analysis showed that the dry weight of the standard compliance and the availability of regular hemodialysis treatment Statistically significant (P <0.05). Conclusion The compliance of dry weight and whether regular hemodialysis treatment are the main risk factors of poor blood pressure control in maintenance hemodialysis patients. The patients with maintenance hemodialysis should be correctly evaluated the dry weight of the patients to ensure regular dialysis, A variety of ways to control blood pressure.