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Received:August 16, 2020 Published Online:May 20, 2021
Received:August 16, 2020 Published Online:May 20, 2021
中文摘要: 目的 了解高原地区尿毒症患者的高血压发病情况、危险因素及其血压控制情况,为高原地区尿毒症患者的高血压防治工作提供依据。方法 采用观察性研究方法,选取2017年3月至2018年7月在拉萨市人民医院开始维持性血液透析的尿毒症患者62例。记录患者年龄、性别、原发肾脏疾病、高血压家族史、吸烟习惯、饮酒习惯、运动习惯等基本资料;测量记录患者的身高、体重、血红蛋白,诊室血压及既往最高血压值;记录患者服用降压药物情况。对尿毒症患者合并高血压情况进行影响因素分析。结果 62例尿毒症患者中,合并高血压59例(95.2%),其中高血压1、2、3级的合并率分别为30.6%、29.0%、35.5%。单因素分析显示,正常血压或高血压1级组与高血压2~3级组在超重、有饮酒习惯、无运动习惯、有高血压家族史、合并中重度贫血方面差异有统计学意义(P<0.05,P<0.01);多因素Logistic回归分析显示,高血压家族史是尿毒症合并高血压2～3级的独立危险因素（OR=5.589，P<0.05）。高原地区绝大多数尿毒症患者均服用降压药物,58.1%患者服用二种及以上降压药物联合治疗。患者透析前的血压达标率为49.2%。结论 高原地区尿毒症患者合并高血压的情况非常严重,其危险因素与平原地区及一般人群相比存在特殊性,血压控制情况不理想。高原地区的医学工作者,需要特别重视高血压这一尿毒症的并发症,积极控制各项危险因素,努力提高血压达标率。
Abstract:Objective To investigate the prevalence,risk factors and blood pressure control of hypertension and provide basis for the prevention and treatment of hypertension in patients with uremia in plateau area.Methods Using observational research methods,62 uremic patients who started receiving maintenance hemodialysis in Lhasa People′s Hospital from March 2017 to July 2018 were selected.The basic information of the patients,including age,gender,primary kidney disease,family history of hypertension,smoking and drinking habits,exercise habits and other basic data were recorded.The patients′s height,weight,hemoglobin level,the blood pressure in consultation room and the previous highest blood pressure were measured and recorded.The patients taking antihypertensive drugs were observed and recorded.Influencing factors of uremia patients with hypertension was analyzed.Results The percentage of uremic patients complicated with hypertension was 95.2%(59/62),and the combination rates of uremia with grade 1,grade 2 and grade 3 hypertension were 30.6%,29.0% and 35.5%,respectively.Univariate analysis showed that there were significantly different between two groups in overweight,drinking habit,without exercise habit,family history of hypertension and moderate to severe anemia(P<0.05 ,P<0.01 ).Multivariate regression analysis showed that family history of hypertension was an independent risk factor of uremia with stage 2-3 hypertension in this population(OR=5.589,P<0.05 ).The majority of uremic patients in plateau area took antihypertensive drugs,and 58.1% of them took two or more antihypertensive drugs.The control rate of blood pressure before dialysis was 49.2%.Conclusions Uremic patients complicated with hypertension are more prominent with special risk factors in plateau area compared with plain areas and the general population.Control rate of blood pressure is unsatisfactory.Medical workers should pay more attention to hypertension in patients with uremia,actively control various risk factors and strive to improve the control rate of blood pressure.
keywords: Plateau area Uremia Hypertension Risk factor
文章编号： 中图分类号：R682.5 R544.1 文献标志码：B
基金项目:北京市医院管理局重点医学专业发展计划建设项目(ZYLX201824);西藏自治区自然科学基金组团式援藏医学项目(XZ2017ZR-ZYZ45)
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