南京医科大学学报（自然科学版）2017，Vol.37Issue(9)：1188-1192,5.DOI:10.7655/NYDXBNS20170924
维持性血液透析患者难治性高血压相关危险因素分析
Risk factors for treatment resistant hypertension in continuous hemodialysis patients
摘要
Abstract
Objective:To identify risk factors associated with treatment resistant hypertension(TRH) and easily detectable through routine blood tests in chronic kidney disease (CKD) patients,who received hemodialysis.Methods:One hundred and seventy-four CKD patients with hypertension receiving hemodialysis between December 2009 and June 2015 were enrolled in this study.Of these patients,69 patients had TRH;the other 105 patients had not.Univariate and multivariate logistic regression analysis was used to assess risk factors associated with TRH.Results:In our study population,the gender distribution,serum level of creatinine and hemodialysis duration were comparable between two groups.The mean age,serum leves of uric acid(UA),white blood cell numbers,aspertate aminotransferase(AST),gamma-glutamyl transferase(GGT) and adenosine deaminase(ADA) were lower in the case group than those in the control group.The serum level of calcium and albumin(ALB) was higher in the case group than that in the control group.Age younger than 40 (OR:3.350,P=0.010),GGT less than 20 U/L (OR:2.554,P=0.024),10 ≤ AST＜ 15 U/L (OR:2.499,P=0.011),and ADA less than 12 U/L(OR:2.259,P=0.044) were positively correlated with TRH.Meanwhile,serum level of ALB less than 41 g/L (OR:0.298,P=0.002) was negatively correlated with TRH.Stepwise multi-variate logistic regression showed that ALB was positively (OR:1.130,P=0.002) and ADA was negatively (OR:0.900,P=0.027) correlated with TRH.Conclusion:The younger age (＜40 years) and lower serum level of GGT(＜20 U/L),AST(10 U/L≤AST＜15 U/L) and ADA(＜12 U/L) are risk factors,and serum levels of ADA decreasing and ALB increasing are independent risk factors for TRH in hemodialysis patients.关键词
血液透析/难治性高血压/危险因素Key words
hemodialysis/treatment resistant hypertension/risk factors分类
医药卫生引用本文复制引用
曹欢,张承宁,盛燕辉,孔祥清,孙伟..维持性血液透析患者难治性高血压相关危险因素分析[J].南京医科大学学报（自然科学版）,2017,37(9):1188-1192,5.基金项目
江苏省六大人才高峰项目(B类2015-WSN-029) （B类2015-WSN-029）
