维持性血液透析患者透析中高血压影响因素探讨

目的分析血液透析中心维持性血液透析患者高血压的控制情况及血压控制不佳的相关性因素。方法对我院肾内科行血液维持性透析患者的初始和进行综合个体化治疗6个月后血压的控制情况进行分析,并对维持性血液透析患者高血压特点及控制不满意的原因进行分析。结果维持性血液透析高血压患者初始较6月后在血白蛋白、透前肌酐、磷、体重增长率、降压药剂量、收缩压、舒张压上存在显著性差异（P〈0.05）。结论水钠潴留是引起高血压的主要因素,透析间期体重增长过多、透析不充分也是透析前影响收缩压的危险因素,合理调整透析方案,合理使用降压药,有效控制透析间期体重增长,是治疗维持性血液透析患者高血压的基本途径。

Study on Influencing Factors of Hypertension during Hemodialysis in Patients with Maintenance Hemodialysis

Objective To analyze the controlling situation of hypertension in patients with maintenance hemodialysis and the factors associated with poorly-controlled hypertension during hemodialysis. Methods The controlling situations of hypertension in patients with maintenance hemodialysis treated with initial and comprehensive individual therapy for 6 months in our department were summerized and analyzed. The characteristics of hypertension during hemodialysis and factors associated with poorly-controlled hypertension were analyzed. Results The differences of blood albumin, serum creatinine before hemodialysis, phosphorus, weight growth rate, antihypertensive drug doses, systolic blood pressure and diastolic blood pressure between initial hemodialysis and 6 months after hemodialysis were statistically significant （P 0.05）. Conclusions Water-sodium retention is the main cause for hypertension. Excessive weight increase and inadequate hemodialysis are the risk factors influencing systolic pressure. Rational adjustment of the dialysis scheme, reasonable application of hypotensive drugs, and effective control of weight increase during hemodialysis are the essential way to treat hypertension in patients with maintenance hemodialysis.