本文選題：血液透析 + 難治性高血壓　； 參考：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2017年09期

【摘要】：目的 :從普通血液和生化指標(biāo)中尋找與維持性血液透析患者難治性高血壓(treatment resistant hypertension,TRH)相關(guān)的危險(xiǎn)因素,為透析患者的高血壓治療提供幫助。方法:2009年12月—2015年6月在南京醫(yī)科大學(xué)第一附屬醫(yī)院行規(guī)律血液透析的高血壓患者174例,其中病例組TRH患者69例,對(duì)照組非TRH患者105例。采用Logistic回歸分析,尋找與TRH相關(guān)的危險(xiǎn)因素。結(jié)果:兩組患者性別、肌酐水平和透析時(shí)長(zhǎng)上差異無統(tǒng)計(jì)學(xué)意義。病例組平均年齡、尿酸、血白細(xì)胞、天門冬氨酸氨基轉(zhuǎn)移酶(aspertate aminotransferace,AST)、谷氨酰轉(zhuǎn)肽酶(gamma-glutamyl transferase,GGT)和腺苷脫氨酶(adenosine deaminase,ADA)水平均顯著低于對(duì)照組;而病例組血清鈣和白蛋白(albumin,ALB)顯著高于對(duì)照組。單因素Logistic回歸顯示:年齡40歲(OR:3.350,P=0.010)、GGT20 U/L(OR:2.554,P=0.024)、10 U/L≤AST15 U/L(OR:2.499,P=0.011)、ADA12 U/L(OR:2.259,P=0.044)是透析患者TRH的危險(xiǎn)因素;ALB41 g/L是保護(hù)因素(OR:0.298,P=0.002)。逐步法多因素Logistic回歸分析顯示:ALB水平與TRH呈正相關(guān)(OR:1.130,P=0.002),ADA水平與TRH呈負(fù)相關(guān)(OR:0.900,P=0.027)。結(jié)論:年齡40歲、血清GGT20 U/L、10≤AST15 U/L和ADA12 U/L是維持性血液透析患者TRH的危險(xiǎn)因素,而血清ADA降低和血清ALB升高是TRH的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to find out the risk factors related to refractory hypertension treatment resistant hypertension in patients with maintenance hemodialysis from the common blood and biochemical parameters, and to provide help for the treatment of hypertension in hemodialysis patients.Methods: from December 2009 to June 2015, 174 patients with hypertension underwent regular hemodialysis in the first affiliated Hospital of Nanjing Medical University, including 69 TRH patients in the case group and 105 non- patients in the control group.Logistic regression analysis was used to find the risk factors associated with TRH.Results: there was no significant difference in sex, creatinine level and duration of dialysis between the two groups.The mean age, uric acid, leukocyte, aspertate aminotransferacea, glutamyl transferase GGTs and adenosine deaminase adenosine deaminase ADAA were significantly lower in the case group than those in the control group, while the serum calcium and albumin albumin levels in the case group were significantly higher than those in the control group.The univariate Logistic regression analysis showed that the age of 40 years old was OR 3.350 / P 0.010 / GGT20 / L: 2.554U / L: 0.024U / L 鈮，

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