维持性透析患者低血压状态相关因素分析

目的：探讨维持性血液透析（MHD）患者慢性低血压状态的发生的影响因素。方法：收集近3年来进行透析的252例MHD患者慢性低血压状态发生情况，回顾性分析患者进入透析时的基础状态指标，包括一般情况、病史资料、体检情况、实验室指标等，并寻找与慢性低血压发生的相关因素。结果：本组MHD患者中并发慢性低血压状态的发生率为23．02％，低血压组与未发生低血压组相比，两组在年龄、糖尿病史、冠心病史、身体质量指数、左室功能、白蛋白水平、血脂、C反应蛋白等方面的差异有显著性意义，多元分析表明高龄、糖尿病、低蛋白血症、C反应蛋白是MHD患者并发慢性低血压状态的主要危险因素。结论：高龄、糖脂代谢紊乱、营养不良和炎症状态与MHD患者慢性低血压状态有关，可作为透析低血压状态的早期预测因素。

Analysis of Related Factors of Chronic Hypotension in Patients With Maintenance Hemodialysis

Objective： To explore the related factors of occurence of chronic hypotension （CHP） in patients with maintenance hemodialysis （MHD）. Methods： The occurrence of chronic hypotension in 252 cases with MHD was investigated. The basic indexes, including the general condition, medical history, physical signs, laboratory findings at initiation of dialysis were analyzed retrospectively. The related factors of chronic hypotension were investigated. Results： The incidence of complicating chronic hypotension in patients with MHD was 23.02%. There were significant differences in age, history of diabetes and coronary heart disease, body mass index, left ventricular function, levels of serum albumin, blood lipids and C-reactive protein between the two groups. Multivariate logistic regression analysis showed that the old age, diabetes, hypoproteinemia, C-reactive protein were the major risk factors of complicating chronic hypotension in patients with MHD. Conclusions： The old age, glucose and lipid metabolic disorders, malnutrition and inflammation are related to chronic hypotension in patients with MHD, and can be used as early predictors of chronic hypotension.