摘要
目的分析维持性血液透析(MHD)终末期肾性高血压病患者N末端脑钠肽前体(NT-proBNP)、血压变异性(BPV)与心血管事件发生的相关性。方法回顾性分析2015年10月9日—2018年1月12日河北北方学院附属第二医院肾内科接受MHD治疗>6个月终末期肾病伴高血压病患者232例临床资料,根据是否发生心血管不良事件分为心血管事件组101例和非心血管事件组131例。分析比较2组患者性别、年龄、糖尿病病史、血液透析期间体质量增长率、血生化指标等临床资料的差异,运用Logistic回归分析筛选患者心血管不良事件发生的危险因素。结果 2组患者透析期间体质量增长率、糖尿病病史、NT-proBNP、收缩压变异标准差(SBP-SD)、收缩压变异系数、舒张压变异标准差(DBP-SD)、舒张压变异系数方面比较差异均有统计学意义(t/P=7.534/0.032、8.023/0.007、6.464/0.023、6.054/0.021、5.667/0.012、6.164/0.008、7.537/0.004);多因素Logistic回归分析表明,NT-proBNP、SBP-SD、DBP-SD为行MHD治疗的终末期肾性高血压病患者发生心血管不良事件的独立危险因素(OR=49.656,P=0.006,95%CI 6.043～231.344;OR=3.423,P=0.021,95%CI 1.365～9.763;OR=5.768,P=0.017,95%CI 3.573～12.546)。结论行MHD治疗的终末期肾性高血压病患者心血管不良事件与透析期间体质量增长率、糖尿病病史、NT-proBNP及血压变异性(BPV)相关,其中NT-proBNP、SBP-SD和DBP-SD是发生心血管不良事件的独立危险因素。
Objective To analyze the correlation between N-terminal pro-brain natriuretic peptide(NT-proBNP),blood pressure variability(BPV)and cardiovascular events in patients with end-stage renal hypertension after maintenance hemodialysis(MHD).Methods A retrospective analysis was made of 232 cases of end-stage renal disease with hypertension treated by MHD from October 9,2015 to January 12,2018 in the Department of Nephrology,Second Affiliated Hospital of Hebei Northern University.According to whether cardiovascular adverse events occurred,101 cases were divided into cardiovascular events group and 131 cases into non-cardiovascular events group.The differences of clinical data such as sex,age,history of diabetes mellitus,and growth rate of body mass during hemodialysis and blood biochemical indexes between the two groups were analyzed and compared.The risk factors of cardiovascular adverse events were screened by logistic regression analysis.Results The differences in body mass growth rate,diabetes history,NT-proBNP,systolic blood pressure variation standard deviation(SBP-SD),systolic blood pressure coefficient of variation,diastolic blood pressure variation standard deviation(DBP-SD),and diastolic blood pressure coefficient of variation were compared between the two groups.Statistical significance(t/P=7.534/0.032,t/P=8.023/0.007,t/P=6.464/0.023,t/P=6.054/0.021,t/P=5.667/0.012,t/P=6.164/0.008,t/P=7.537/0.004);Multivariate logistic regression analysis showed that NT-proBNP,SBP-SD,DBP-SD were independent risk factors for cardiovascular adverse events in patients with end-stage renal hypertension treated with MHD(OR=49.656,P=0.006,95%CI 6.043 to 231.344;OR=3.423,P=0.021,95%CI 1.365 to 9.763;OR=5.768,P=0.017,95%CI 3.573 to 12.546).Conclusion Cardiovascular adverse events in end-stage renal hypertension patients treated with MHD were associated with body mass growth rate,diabetes history,NT-proBNP and BPV during dialysis.NT-proBNP,SBP-SD and DBP-SD were independent risk factors for cardiovascular adverse events.
作者
李迎婕
魏晓岩
贾军利
吴晓芸
王会芳
王慧
吴清雷
陈晓丹
时秀文
LI Yingjie;WEI Xiaoyan;JIA Junli;WU Xiaoyun;WANG Huifang;WANG Hui;WU Qinglei;CHEN Xiaodan;SHI Xiuwen(Department of Nephrology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China)
出处
《疑难病杂志》
CAS
2019年第4期364-368,共5页
Chinese Journal of Difficult and Complicated Cases
基金
张家口市科学技术研究与发展计划项目(1821038D)
