中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (11): 895-898.doi: 10.3969/j.issn.1671-4091.2025.11.004

• 健康体重·医者先行 • 上一篇    下一篇

维持性血液透析患者透析间期体质量增长率与心血管功能的关系

郭学娜   高 艳   李雪梅   任建伟   

  1. 100012 北京，航空总医院1肾内科 2超声科
  • 收稿日期:2025-04-14 修回日期:2025-05-15 出版日期:2025-11-12 发布日期:2025-11-12
  • 通讯作者: 郭学娜 E-mail:guoxuena2008@163.com

Relationship between percentage of interdialysis weight gain and cardiovascular function in maintenance hemodialysis patients

GUO Xue-na,GAO Yan ,LI Xue-mei,REN Jian-wei   

  1. Department of Nephrology, 2Department of Ultrasonography, Aviation General Hospital,Beijing 100012,China
  • Received:2025-04-14 Revised:2025-05-15 Online:2025-11-12 Published:2025-11-12
  • Contact: 100012 北京，航空总医院1肾内科 E-mail:guoxuena2008@163.com

摘要： 目的  探讨维持性血液透析(maintenance hemodialysis，MHD)患者透析间期体质量增长率(percentage of interdialysis weight gain，PIWG)与心血管功能的关系。 方法  回顾性分析2024年9月—11月在航空总医院血液透析中心接受维持性血液透析治疗的患者，根据PIWG分为低PIWG组(PIWG＜5%)和高PIWG组(PIWG≥5%)，收集患者人口学资料、生化指标、血压、超声心动图指标等进行组间比较及多因素相关分析。 结果  共纳入100例患者，其中低PIWG组64例、高PIWG组36例。高PIWG组透析前收缩压(t=-3.380，P=0.001)、透析前脉压(t=-2.276，P=0.025)、N末端B型钠尿肽前体(Z=-3.160， P=0.002)、左心房前后径(t=-3.573，P=0.001)、左心房容积指数(t=-3.380，P=0.001)、室间隔厚度(Z=     -2.410，P=0.016)、舒张早期二尖瓣口前向血流速度(E)与舒张早期二尖瓣间隔侧心肌运动速度(E’)比值(t=-3.003，P=0.003)高于低PIWG组，射血分数(Z=2.246，P=0.025)低于低PIWG组。相关分析显示PIWG与N末端B型钠尿肽前体(r=0.395，P=0.001)、透析前收缩压(r=0.423，P=0.001)、透析前脉压(r=0.277，P=0.005)、左心房容积指数(r=0.211，P=0.035)、室间隔厚度(r=0.201，P=0.045)、E/E’(r=0.224，P=0.025)呈正相关。 结论  PIWG与MHD患者心血管功能密切相关，PIWG影响MHD患者的收缩压、脉压及心脏功能。

关键词: 维持性血液透析, 透析间期体质量增长率, 心血管功能, 超声心动图

Abstract: bjective  To investigate the relationship between the percentage of interdialysis weight gain (PIWG) and cardiovascular function in maintenance hemodialysis (MHD) patients.  Methods  A retrospective analysis was conducted on patients receiving MHD at the Hemodialysis Center of Aviation General Hospital between September and November 2024. Based on PIWG, patients were divided into a low PIWG group (PIWG＜5%,  n=64) and a high PIWG group (PIWG≥5%, n=36). Intergroup comparisons and multivariate correlation analyses were conducted for statistical evaluation of demographic data, biochemical parameters, blood pressure, and echocardiographic parameters between the two groups.   Results   A total of 100 patients were enrolled, including 64 in the low PIWG group and 36 in the high PIWG group. The high PIWG group exhibited higher pre-dialysis systolic blood pressure (t =-3.380, P =0.001), pre-dialysis pulse pressure (t =-2.276, P = 0.025), N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (Z =-3.160, P =0.002), left atrial anteroposterior diameter (t =-3.573, P=0.001), left atrial volume index (t =-3.380, P =0.001), interventricular septal thickness (Z=-2.410, P=0.016), and E/e’ ratio (t =-3.003, P =0.003) , but lower left ventricular ejection fraction (Z=2.246, P=0.025) compared to the low PIWG group. Correlation analysis revealed that PIWG was positively associated with NT-proBNP (r=0.395, P=0.001), pre-dialysis systolic blood pressure (r=0.423, P= 0.001), pre-dialysis pulse pressure (r=0.277, P=0.005), left atrial volume index (r=0.211, P=0.035), interventricular septal thickness (r=0.201, P=0.045), and E/e’ ratio (r=0.224, P=0.025).  Conclusion  PIWG is closely associated with cardiovascular function in MHD patients, influencing systolic blood pressure, pulse pressure, and cardiac structural/functional parameters.

Key words: Maintenance hemodialysis, Percentage of interdialysis weight gain, Cardiovascular function, Echocardiography

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