中国血液净化

中国血液净化 ›› 2012, Vol. 11 ›› Issue (04): 206-209.doi: 10.3969/j.issn.1671-4091.2012.04.00

• 临床研究 • 上一篇    下一篇

血液透析糖尿病与非糖尿病患者血压变异性的比较

李秀季 姜立萍 黄 雯   

  1. 首都医科大学附属北京同仁医院血液透析中心
  • 收稿日期:2011-12-05 修回日期:1900-01-01 出版日期:2012-04-12 发布日期:2012-04-12
  • 通讯作者: 黄雯

Comparison of blood pressure variability in hemodialysis patients with and without diabetes mellitus

LI Xiu-ji, JIANG Li-ping, HUANG Wen.   

  • Received:2011-12-05 Revised:1900-01-01 Online:2012-04-12 Published:2012-04-12

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摘要： 【摘要】目的 探讨维持性血液透析(maintenance hemodialysis, MHD)糖尿病与非糖尿病患者血压变异性(blood pressure variability, BPV)的差异。方法 选取血液透析中心MHD患者47例，分为糖尿病组(19例)和非糖尿病组(28例)，比较两组间透析前及透析中平均血压及BPV的差异。BPV用多个血压读数的标准差(standard deviation, SD)和变异系数(coefficient of variation,CV)来表示。结果 糖尿病组透前血浆白蛋白和血肌酐水平分别为(41.52±3.84)g/L 和(742.41±199.58)umol/L，均显著低于非糖尿病组(44.02±3.48)g/L 和(1015.26±278.04)umol/L(P＜0.05)，而两组患者年龄、性别构成比、血红蛋白、总钙、无机磷、超滤量、每公斤体质量超滤量及尿素清除指数(Kt/V)差异均无统计学意义(P＞0.05)。糖尿病组与非糖尿病组服用降压药物种类的比例差异无统计学意义(P＞0.05)。糖尿病组和非糖尿病组患者透析前平均收缩压(systolic blood pressure, SBP)分别为(162±15)mmHg(1mmHg=0.133kPa)和(150±14）mmHg，SBP-SD分别为(15.39±5.13)mmHg和(11.35±4.65)mmHg，SBP-CV分别为(9.53±3.14)%和(7.53±2.90)%，△SBP分别为(47±15)mmHg和(35±13)mmHg，差异均有统计学意义(P＜0.05)，而两组透析前平均舒张压(diastolic blood pressure, DBP)、DBP-SD和DBP-CV比较，差异无统计学意义(P＞0.05)。糖尿病组和非糖尿病组患者透析中SBP-SD分别为(19.07±6.07)mmHg和(13.93±3.56)mmHg，SBP-CV分别为(13.25±4.08)%和(9.71±2.65)%，差异均有统计学意义(P＜0.05)，而两组透析中平均SBP、平均DBP、DBP-SD及DBP-CV比较，差异无统计学意义(P＞0.05)。 结论 MHD糖尿病较非糖尿病患者血压控制更差，无论是透析前还是透析中MHD糖尿病患者收缩压变异性更大。

关键词: 血液透析, 糖尿病, 血压变异性

Abstract: 【Abstract】Objective To investigate the difference of blood pressure variability (BPV) between maintenance hemodialysis (MHD) patients with diabetes mellitus and those without diabetes mellitus.  Methods We recruited 47 MHD patients with stable disease status in the Hemodialysis Center of Beijing Tongren Hospital. They were divided into diabetes group and non-diabetes group. Pre-dialytic and intradialytic mean blood pressure and BPV were compared between the two groups. Standard deviation (SD) and coefficient of variation (CV) were used for the evaluation of BPV.  Results In diabetes group, pre-dialytic levels of plasma albumin and serum creatinine were 41.52±3.84 g/L and 742.41±199.58 μmol/L, respectively, significantly lower than those in non-diabetes group (44.02±3.48 g/L and 1015.26±278.04 μmol/L, respectively; P＜0.05). There were no significant differences in age, ratio of sex, hemoglobin, total calcium, inorganic phosphorus, ultrafiltration volume (UFV), UFV/W, Kt/V, and anti-hypertension treatment between the two groups (P＞0.05). In diabetes group, pre-dialytic mean systolic blood pressure (SBP), SBP-SD, SBP-CV and △SBP were 162±15mmHg, 15.39±5.13mmHg, 9.53±3.14% and 47±15mmHg, respectively, significantly higher than those in non-diabetes group (150±14mmHg, 11.35±4.65mmHg, 7.53±2.90% and 35±13mmHg, respectively; P＜0.05). There were no significant differences in pre-dialytic mean diastolic blood pressure (DBP), DBP-SD and DBP-CV between the two groups (P＞0.05). In diabetes group, intradialytic SBP-SD and SBP-CV were 19.07±6.07mmHg and 13.25±4.08%, respectively, significantly higher than those in non-diabetes group (13.93±3.56mmHg and 9.71±2.65%, respectively; P＜0.05). There were no significant differences in intradialytic mean SBP, mean DBP, DBP-SD and DBP-CV between the two groups (P＞0.05). Conclusion In MHD patients with diabetes, blood pressure control was relatively difficult, and pre-dialytic and intradialytic SBP variability were more extensive.

Key words: Hemodialysis, Diabetes mellitus, Blood pressure variability