老年医学与保健2011，Vol.17Issue(5)：288-292,5.DOI:10.3969/j.issn.1008-8296.2011-05-11
老年维持性血液透析患者透析间期血压节律的影响因素分析
Investigation of factors of circadian rhythm of interdialytic ambulatory blood pressure in elderly maintenance hemodialysis patients
王莹 1牛建英 1范伟锋 1罗丽红 1钱英俊 1张绮 1顾勇1
作者信息
- 1. 200240,上海市,复旦大学附属上海市第五人民医院肾内科
- 折叠
摘要
Abstract
Objective To investigate factors that influence circadian rhythm of interdialytic ambulatory blood pressure in elderly patients with maintenance hemodialysis (MHD). Methods Ambulatory blood pressure monitoring (ABPM) was conducted in twenty-eight elderly MHD patients between two dialysis sessions. The data of ABPM as well as echocardio-graphy and serum biochemical indicators were examined. Two groups were identified with different ranges of decline rate of nocturnal systolic blood pressure: normal and abnormal blood pressure rhythm groups. Clinical records on epidemiologic, hematological, ABPM and cardiac ultrasonic aspects of the two groups were compared by independent-samples T test or Fisher exact method. Logistic regression model was used to analysis the risk factors influencing circadian rhythm of interdialytic ambulatory blood pressure in elderly MHD patients. Results (1) The mean parathyroid hormone level, ambulatory arterial stiffness index, symmetrical ambulatory arterial stiffness index, left ventricular mass index in the abnormal blood pressure rhythm group were obviously higher than those in the normal group and these differences were statistically significant (P < 0.05). (2) Multivariate Logistic regression proportional analyses showed that parathyroid hormone, symmetrical ambulatory arterial stiffness index, left ventricular hypertrophy were the independent risk factors of circadian rhythm of interdialytic ambulatory blood pressure in the elderly MHD patients. Conclusion Secondary hyperparathyroidism, arterial sclerosis and left ventricular hypertrophy were the independent risk factors influencing nocturnal systolic blood pressure fall and blood pressure rhythm in elderly maintenance hemodialy sis patients.关键词
老年/血液透析/动态血压Key words
Elderly patients/ Hemodialy sis/ Ambulatory blood pressure分类
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王莹,牛建英,范伟锋,罗丽红,钱英俊,张绮,顾勇..老年维持性血液透析患者透析间期血压节律的影响因素分析[J].老年医学与保健,2011,17(5):288-292,5.
