摘要
目的了解安徽省维持性血液透析（MHD）患者高血压的患病率及治疗情况，并探讨影响MHD患者高血压控制的因素。方法横断面调查2014年1月1日至2014年3月31日皖中、皖南、皖北的26家医院（其中三级医院19家、二级医院7家）血液净化中心MHD成年患者2724例。调查内容包括人口学特征、原发病、并发症、用药情况、透析情况、实验室检查等资料。分析安徽省MHD患者高血压患病率、治疗率和控制率。Logistic回归分析评估影响MHD患者血压达标（收缩压〈140mrnHg且舒张压〈90mmHg）的因素。结果（1）安徽省MHD患者高血压患病率为87．0％，治疗率为93．2％，控制率为23．9％。平均收缩压为（145．90~21．18）mmHg，舒张压为（83．60-＋12．21）mmHg。抗高血压治疗患者中钙离子拮抗剂为最常用抗高血压药物，使用率为88．2％；45．7％患者联用2种抗高血压药，26．2％用1种抗高血压药，21．7％联用3种抗高血压药，6．4％联用4种或以上。（2）与非高血压组患者相比，高血压组年龄、体重指数（BMI）、磷、透析前收缩压及舒张压较高，而血红蛋白、尿素清除指数较低，差异均有统计学意义（均P〈0．05）。（3）多因素Logistic回归分析发现，血钙〉2．50mmol／L（OR=2．084，95％CI：1．008～4．307，P=0．047）与血压达标呈正相关，吸烟（OR=0．594，95％CI：0．356—0．911，P=0．046）、BMI18．5～23．9kg／m2（OR=0．516，95％vs：0．293～0．907，P=0．022）与血压达标呈负相关。结论安徽省MHD患者高血压患病率高，控制率低。高血钙可能为血压达标的保护因素，而吸烟、BMI可能为血压达标的危险因素。
Objective To understand the prevalence, treatment and influence factors of hypertension in maintenance hemodialysis （MHD） patients in Anhui Province. Methods A total of 2724 adult patients on MHD from January F＇ 2014 to March 31- 2014 in 26 hospitals of southern, northern and central Anhui Province were investigated. Their demographic characteristics, primary disease, complications, medications, dialysis and laboratory examination were explored. The prevalence treatment rate and control rate of hypertension were analyzed. Associated factors for controlling hypertension [systolic blood pressure （SBP） 〈 140 mmHg and diastolic blood pressure （DBP） 〈 90 mmHg] were assessed by logistic regression analysis, Results （1） The prevalence of hypertension in the hemodialysis patients was 87.0%. Their treatment rate and control rate were 93.2% and 23.9% respectively. The average of SBP was （145.90±21.18） mmHg, and the DBP on average was （83.60±12.21） mmHg. The most commonly used anti-hypertensive drug is calcium channel blocker （88.2%）. Over one third （45.7%） of patients were treated with two kinds of anti-hypertensive drug, 26.2% with 1 kind, 21.7% with 3 kinds, and 6.4% with 4 kinds or more. （2） Compared with non- hypertension patients, patients with hypertension have older age, higher body mass index （BMI）, phosphorus, SBP and DBP, as well as lower hemoglobin and Kt/V （all P 〈 0.05）. （3） The multivariate logistic regression analysis showed that Ca 〉 2.50 mmol/L （OR=2.084, 95%CI 1.008-4.307, P=0.047） positively correlated with controlling hypertension, while smoke （OR=0.594, 95%CI 0.356-0.911, P=0.046） and BMI 18.5 - 23.9 kg/m2 （OR=0.516, 95% CI 0.293- 0.907, P=0.022） negatively correlated with it. Conclusions High prevalence yet low control rate of hypertension in MHD patients in Anhui Province were observed. Hypocalcemia may be a protective factor for hypertension control, while smoke and BMI may be risk factors for it.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2018年第1期17-23,共7页
Chinese Journal of Nephrology
关键词
肾透析
高血压
抗高血压药
Renal dialysis
Hypertension
Antihypertensive agents
