维持性血液透析患者脉搏波传导速度影响因素的临床研究

Influencing factors of pulse wave velocity in patients with maintenance hemodialysis

摘要:

目的：探讨维持性血液透析患者脉搏波传导速度影响因素。方法：选取皖南医学院第一附属医院维持性血液透析患者70例，采用动态血压仪检测患者24 h血压；同时监测患者的颈动脉-股动脉脉搏波速度（carotid-femoral pulse wave velocity，cf－PWV），生化分析仪检测患者生化指标，ELISA检测患者的CRP、BNP、NTproBNP、Troponin I、Troponin T等，并进行简单相关性分析，进一步行线性回归分析。结果：①维持性血液透析患者cfPWV水平与年龄、24SBP、dSBP、nSBP、24PP、dPP、nPP、BNP呈正相关，r值分别为0.304、0.540、0.548、0.506、0.643、0.651、0.595、0.294；P值分别为0.010、0.000、0.000、0.000、0.000、0.000、0.000、0.014；维持性血液透析患者cfPWV水平与透析龄、Ca、24HR、nHR呈负相关，r值分别为-0.249、-0.252、-0.311、-0.255；P值分别为0.038、0.038、0.006、0.045。②多因素线性回归分析显示维持性血液透析患者cfPWV主要影响因素有dPP、Ca。结论：动脉差与血钙可能是维持性血液透析患者脉搏波传导速度的影响因素。

Abstract:

Objective：To explore the influencing factor of pulse wave velocity in patients with maintenance hemodialysis. Methods：Seventy patients with maintenance hemodialysis were selected from blood purification center of the First Affiliated Hospital of Wannan Medical College. The blood pressure of 24 hours was measured by dynamic blood pressure meter. CfPWV was monitored and biochemi－cal markers were measured by biochemical analyzer. CRP，BNP，NTproBNP，Troponin I and Troponin T were measured by enzyme-linked immunosorbent assay（ELISA）. A simple correlation analysis was performed and further linear regression analysis was per－formed. Results：①Levels of cfPWV were positively correlated with age，24SBP，dSBP，nSBP，24PP，dPP，nPP and BNP in patients with maintenance hemodialysis，r=0.304，0.540，0.548，0.506，0.643，0.651，0.595，0.294；P=0.010，0.000，0.000，0.000，0.000，0.000，0.000，0.014，respectively. Levels of cfPWV were negatively correlated with dialysis age，Ca，24HR and nHR in maintenance hemodialysis patients，r=-0.249，-0.252，-0.311，-0.255；P=0.038，0.038，0.006，0.045，respectively. ②Multivariate regression analysis showed that main influencing factors of cfPWV in patients with maintenance hemodialysis were dPP and Ca. Conclusion：Arterial pressure and serum calcium may be influencing factors of pulse wave velocity in patients with maintenance hemodialysis.