维持性血液透析患者难治性高血压相关危险因素分析

发布时间：2018-04-18 04:38

  本文选题：血液透析 + 难治性高血压　； 参考：《南京医科大学学报(自然科学版)》2017年09期

【摘要】：目的 :从普通血液和生化指标中寻找与维持性血液透析患者难治性高血压(treatment resistant hypertension,TRH)相关的危险因素,为透析患者的高血压治疗提供帮助。方法:2009年12月—2015年6月在南京医科大学第一附属医院行规律血液透析的高血压患者174例,其中病例组TRH患者69例,对照组非TRH患者105例。采用Logistic回归分析,寻找与TRH相关的危险因素。结果:两组患者性别、肌酐水平和透析时长上差异无统计学意义。病例组平均年龄、尿酸、血白细胞、天门冬氨酸氨基转移酶(aspertate aminotransferace,AST)、谷氨酰转肽酶(gamma-glutamyl transferase,GGT)和腺苷脱氨酶(adenosine deaminase,ADA)水平均显著低于对照组;而病例组血清钙和白蛋白(albumin,ALB)显著高于对照组。单因素Logistic回归显示:年龄40岁(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的危险因素;ALB41 g/L是保护因素(OR:0.298,P=0.002)。逐步法多因素Logistic回归分析显示:ALB水平与TRH呈正相关(OR:1.130,P=0.002),ADA水平与TRH呈负相关(OR:0.900,P=0.027)。结论:年龄40岁、血清GGT20 U/L、10≤AST15 U/L和ADA12 U/L是维持性血液透析患者TRH的危险因素,而血清ADA降低和血清ALB升高是TRH的独立危险因素。
[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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