中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (06): 450-453.doi: 10.3969/j.issn.1671-4091.2014.06.008

• 临床研究 • 上一篇    下一篇

动态血压监测对血液透析患者预后判断的作用

王松,庄震,何莲,王悦,范敏华   

  1. 北京大学第三医院第三医院肾内科
  • 收稿日期:2014-03-17 修回日期:2014-04-04 出版日期:2014-06-12 发布日期:2014-06-12
  • 通讯作者: 王悦 bjwangyue@sina.com E-mail:bjwangyue@sina.com

Evaluation of Ambulatory Blood Pressure Monitoring on Outcome of Patients with Maintenance Hemodialysis

  • Received:2014-03-17 Revised:2014-04-04 Online:2014-06-12 Published:2014-06-12
  • Contact: Yue WANG E-mail:bjwangyue@sina.com

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摘要： 【摘要】目的：探讨动态血压监测对维持性血透患者预后判断的价值。方法：2010年3月-7月我院维持性血透患者45例，行24小时动态血压监测后随访至患者死亡或2013年12月31日，对可能影响预后的因素进行单因素和多因素Cox回归分析。结果：平均随访3.5年后死亡9例，其中7例死因为心脑血管疾病，平均动脉压、夜间舒张压最低值、夜间舒张压变异度及非杓型血压与年龄是患者死亡的独立危险因素（HR分别为1.248，1.577，2.101，0.000，1.461，P＜0.05）。结论：动态血压检测所得平均动脉压、夜间舒张压最低值，夜间舒张压变异度、血压节律可能对患者死亡有一定的预测价值。

关键词: 血液透析, 动态血压监测, 死亡

Abstract: 【Abstract】Objective：To investigate the prognostic value of ambulatory blood pressure monitoring (ABPM) on outcome of patients with maintenance hemodialysis. Methods：45 maintenance hemodialysis patients from March to July in 2010 in our hospital were recruited . The data on the demographic, serum biochemical parameters as well as ABPM results of these patients were collected. The patients were followed up until death or December 2013. The long-term survival rates and impact factors were analyzed. Univariate and multivariate analysis Cox regression proportional hazard model were used to analysis the risk factors. Results：Over an average follow-up of 3.5 years，9 patients died. 7 were died of cardiovascular and cerebrovascular disease. Adjusted multivariate analyses showed mean arterial pressure (MAP)，minimum value of diastolic blood pressure (DBP) at night，nighttime DBP variability and non-dipper blood pressure as well as age were independent risk factors for death (HR： 1.248，1.577，2.101，0.000，1.461，respectively). Conclusions：The elevated MAP, minimum value of DBP at night，nighttime DBP variability and the non-dipper blood pressure pattern obtained by ABPM might be of prognostic importance for patients with maintenance hemodialysis.

Key words: Hemodialysis, ambulatory blood pressure monitoring, death