综合治疗干预下维持性血液透析患者季节性血压变化的影响因素分析

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Abstract ObjectiveTo explore the influence factors of the seasonal blood pressure change in patients hypertension given with maintenance hemodialysis under the comprehensive therapy intervention to provide evidence for clinical treatment for the patients.MethodsA total of 60 patients with maintenance hemodialysis treated in outpatient of People′s Hospital of Baoan District in Shenzhen City and Fuyong People′s Hospital of Baoan District in Shenzhen City and this patients were given comprehensive therapy intervention at the same time from January 2015 to June 2016 were selected.The patients were given home blood pressure monitoring,individualized antihypertensive treatment,medication compliance education,sleep quality survey,volume control education,dietary sodium intake and telephone following-up, and ntihypertensive drugs and erythropoietin (EPO)use,blood pressure value,the growth rate of body weight during dialysis period,hemoglobin,creatinine,urea nitrogen and other results in summer(6-8 months)and winter(12-next year of 2 months)in patients were collected,and the above-mentioned indexes between the two groups were compared.ResultsAfter comprehensive treatment,the systolic pressure for patients in summer and winter was(137.7±12.31)mmHg and (143.5±14.78)mmHg respectively,and the diastolic blood pressure was (83.52±10.75)mmHg and (87.2±11.31) mmHg respectively before dialysis,and the differences were statistically significant(P＜0.05).There were no significant differences in the test results of creatinine and urea nitrogen between summer and winter(P＞0.05).Multiple linear regression analysis showed that IDWG(P=0.024),EPO treatment(P=0.027)and sleep time difference(P=0.038)were the influencing factors of seasonal change in blood pressure.ConclusionThe occurrence of elevated blood pressure is influenced by many factors in winter,amog them,IDWG is the main factors affecting winter elevated blood pressure,and being treated with EPO and sleep quality are related influence factors,only the comprehensive treatment and intervention applied in patients with hypertension given with maintenance hemodialysis then the effective treatment plan is put forward for the control the seasonal hypertension.

Key words： Hemodialysis Hypertension Comprehensive therapy intervention Seasonal change of blood pressure

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