Tozawa Masahiko, Iseki Kunitoshi, Iseki Chiho, Oshiro Saori, Yamazato Masanobu, Higashiuesato Yasushi, Tomiyama Nozomi, Tana Takeshi, Ikemiya Yoshiharu, Takishita Shuichi
Third Department of Internal Medicine, University of The Ryukyus, Okinawa, Japan.
Kidney Int. 2002 Dec;62(6):2195-201. doi: 10.1046/j.1523-1755.2002.00665.x.
Few analyses have compared pulse pressure (PP) values in hemodialysis patients with healthy individuals, and they have provided only limited data. We retrospectively examined PP in a large cohort of hemodialysis patients and healthy control subjects.
The relationships of systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP to mean arterial pressure (MAP) levels were investigated in 234 chronic hemodialysis patients and in 682 control subjects matched for age, sex, diabetes mellitus, and body mass index.
In both control and patients, PP was positively correlated with MAP, and the two regression lines were parallel (beta of control subjects = 0.52; beta of hemodialysis patients = 0.57, P = 0.48). According to the regression line, at any MAP level, the PP in hemodialysis patients was significantly higher than that in control subjects: the mean PP difference between control and patients was 19.2 mm Hg (95% CI, 17.2 to 21.1 mm Hg, P < 0.0001). When the relationships between MAP and SBP and that between MAP and DBP were analyzed, the regression lines were also parallel. However, at any MAP level, SBP was higher and DBP was lower in hemodialysis patients than control subjects; the mean SBP difference was 12.8 mm Hg (95% CI, 11.5 to 14.1 mm Hg, P < 0.0001) and mean DBP difference was 6.4 mm Hg (95% CI, 5.7 to 7.0 mm Hg, P < 0.0001).
At any MAP level, hemodialysis patients had a higher SBP, lower DBP, and higher PP values than those control subjects with a normal renal function who were matched for age, sex, diabetes mellitus, and body mass index. Further study is needed to determine whether preventing or reducing an elevated PP improves the prognosis for hemodialysis patients.
很少有分析比较血液透析患者与健康个体的脉压（PP）值，且所提供的数据有限。我们回顾性研究了一大群血液透析患者和健康对照者的脉压。
在234例慢性血液透析患者和682例年龄、性别、糖尿病及体重指数相匹配的对照者中，研究收缩压（SBP）、舒张压（DBP）和脉压与平均动脉压（MAP）水平的关系。
在对照组和患者中，脉压均与平均动脉压呈正相关，且两条回归线平行（对照组β = 0.52；血液透析患者β = 0.57，P = 0.48）。根据回归线，在任何平均动脉压水平下，血液透析患者的脉压均显著高于对照组：对照组与患者的平均脉压差值为19.2 mmHg（95%CI，17.2至21.1 mmHg，P < 0.0001）。分析平均动脉压与收缩压及平均动脉压与舒张压的关系时，回归线同样平行。然而，在任何平均动脉压水平下，血液透析患者的收缩压高于对照组，舒张压低于对照组；平均收缩压差值为12.8 mmHg（95%CI，11.5至14.1 mmHg，P < 0.0001），平均舒张压差值为6.4 mmHg（95%CI，5.7至7.0 mmHg，P < 0.0001）。
在任何平均动脉压水平下，与年龄、性别、糖尿病及体重指数相匹配的肾功能正常的对照者相比，血液透析患者的收缩压更高、舒张压更低、脉压更高。需要进一步研究以确定预防或降低升高的脉压是否能改善血液透析患者的预后。
