【摘要】 目的探讨动态血压监测对维持性血透患者预后判断的价值。方法 2010年3月～7月北京大学第三医院维持性血液透析患者45例,行24h动态血压监测后随访至患者死亡或2013年12月31日,对可能影响预后的因素进行单因素和多因素Cox回归分析。结果平均随访3.5年后死亡9例,其中7例死因为心脑血管疾病,平均动脉压、夜间舒张压最低值、夜间舒张压变异度及非杓型血压与年龄是患者死亡的独立危险因素(HR分别为1.248,1.577,2.101,0.000,1.461,P<0.05)。结论动态血压监测所得平均动脉压、夜间舒张压最低值,夜间舒张压变异度、血压节律可能对患者死亡有一定的预测价值。更多还原

【Abstract】 Objective To investigate the prognostic value of ambulatory blood pressure monitoring(ABPM) in maintenance hemodialysis(MHD) patients. Methods A total of 45 MHD patients treated from March to July in 2010 in our hospital were recruited. Their demographic data, serum biochemical parameters and ABPM results were collected. They were followed up until death or December 2013. The long-term survival rate and its impact factors were analyzed. Univariate and multivariate analyses of Cox regression proportional hazard model were used to analyze the risk factors. Results Over an average follow-up of 3.5 years9 patients died, of which 7 died of cardiovascular or cerebrovascular disease. Adjusted multivariate analyses showed that mean arterial pressure(MAP), minimum value of diastolic blood pressure(DBP) at night, nighttime DBP variability, non-dipper blood pressure and age were the independent risk factors for death(HR=1.248, 1.577, 2.101, 0.000, and 1.461, respectively). Conclusions MAP, minimum value of DBP at night,nighttime DBP variability and non-dipper blood pressure pattern obtained from ABPM may be of prognostic importance for MHD patients.更多还原