本文關(guān)鍵詞： 血液透析 糖尿病腎病 高血壓　出處：《上海醫(yī)學(xué)》2017年01期 　論文類型：期刊論文

【摘要】：目的探討糖尿病腎病(DKD)所致終末期腎病(ESRD)行維持性血液透析(MHD)患者的高血壓情況。方法收集上海市39家血液透析中心558例DKD所致ESRD行MHD患者的高血壓相關(guān)臨床和實(shí)驗(yàn)室檢查資料,并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果 558例患者中高血壓患者共523例,患病率為93.7%。不同性別間高血壓患病率、收縮壓和舒張壓的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05)。接受抗高血壓藥物治療的患者共490例,應(yīng)用藥物治療比例為93.7%(490/523),不同性別間高血壓治療率的差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。使用的降壓藥物以鈣通道阻滯劑(CCB)最多(366例,占74.7%),其次為血管緊張素受體阻滯劑(ARB,166例,占33.9%)和血管緊張素轉(zhuǎn)換酶抑制劑(ACEI,95例,占19.4%)。應(yīng)用1種藥物以CCB最為常用,應(yīng)用2種藥物以CCB聯(lián)合ARB最為常用。128例(24.5%)患者達(dá)到血壓控制靶目標(biāo)(≤140/90 mmHg,1 mmHg=0.133kPa),不同性別間血壓控制率的差異無統(tǒng)計(jì)學(xué)意義(P0.05)。血壓控制組的年齡顯著大于血壓未控制組(P0.05),尿素清除指數(shù)(KT/V)、尿素清除率(URR)、血紅蛋白水平顯著高于血壓未控制組(P值均0.05),高血壓用藥種類顯著少于血壓未控制組(P0.05)。單因素Logistic分析發(fā)現(xiàn),高血壓用藥種類為血壓控制的危險(xiǎn)因素(OR=1.34,95%CI為1.07~1.69,P0.05),年齡(OR=0.96,95%CI為0.94~0.98,P0.05)和血紅蛋白水平(OR=0.98,95%CI為0.97~0.99,P0.05)為血壓控制的保護(hù)因素。逐步多因素Logistic回歸分析發(fā)現(xiàn),患者血壓控制與年齡、高血壓用藥種類和血紅蛋白水平顯著相關(guān),回歸系數(shù)分別為-0.40、0.24、-0.02(P值均0.05),年齡越小、高血壓用藥種類越多、血紅蛋白水平越低,血壓控制越不理想。結(jié)論 DKD所致ESRD行MHD患者的高血壓患病率和治療率均較高,但血壓控制率較低,血壓控制受年齡、血紅蛋白水平、高血壓用藥種類等多種因素影響。
[Abstract]:Objective to investigate the effect of maintenance hemodialysis (MHD) on end-stage nephropathy (ESRD) induced by diabetic nephropathy (DKD). Methods the clinical and laboratory data of 558 ESRD patients with MHD caused by DKD in 39 hemodialysis centers in Shanghai were collected. Results there were 523 cases of hypertension in 558 patients, the prevalence rate was 93.7%. There was no significant difference in systolic blood pressure (SBP) and diastolic blood pressure (DBP) (P < 0.05). 490 patients were treated with antihypertensive drugs and the proportion of patients treated with drugs was 93.790 / 523). There was no significant difference in the treatment rate of hypertension between sexes (P 0.05). The most common antihypertensive drugs were calcium channel blocker CCB in 366 cases (74.775%). The second was angiotensin receptor blocker (ARBN) in 166 cases (33. 9%) and angiotensin converting enzyme inhibitor (ACEI) in 95 cases. 19.4%. CCB is the most commonly used drug. The target of blood pressure control (鈮，

本文編號：1480931