The Influencing Factors Of Blood Pressure Variability And The Relationship Between BPV And TCM Syndrome In Maintenance Hemodialysis Patients

ObjectiveTo explore the influencing factors of blood pressure variability(BPV)and observe the relationship between BPV and TCM syndrome in maintenance hemodialysis(MHD)patients.To provide a theoretical basis for reasonable intervention of Chinese and Western medicine to reduce BPV in MHD patients.MethodsThis study was a cross-sectional retrospective study.Enrolled 180 MHD patients from the Hospital of Chengdu University of TCM.The blood pressure coefficient of variation(BPCV)was calculated from the standard deviation of BP / average BP value×100%.The patients were divided into high and low coefficient of variation groups according to the level of BPCV.Clinical data and laboratory indicators were compared among the 2 groups.Multiple linear regression model was used to analyze the influencing factors of BPV.The patients were divided into different groups based on different TCM syndrome.Clinical data and laboratory indicators were compared among all those groups to observe the relationship between BPV and TCM syndrome in MHD patients.The data were analyzed by SPSS 22.0.ResultsⅠ.The pre-dialysis systolic blood pressure variability(SBPV)was positively correlated with the age,weight gain coefficient and i PTH(p <0.05,or p <0.01),and was negatively correlated with dialysis age and Alb(p <0.05).The SBPV in dialysis was positively correlated with the age,diabetes,weight gain coefficient,actual ultrafiltration volume and i PTH(p <0.05,or p <0.01),and was negatively correlated with dialysis age,CCB usage rate and Alb(p <0.05).Ⅱ.The pre-dialysis diastolic blood pressure variability(DBPV)of was positively correlated with the age,diabetes and i PTH(p <0.05,or p <0.01),and was negatively correlated with the CCB usage rate,TP and Alb(p <0.05).The DBPV in dialysis was positively correlated with age,diabetes and i PTH(p <0.05,or p <0.01).Ⅲ.Among the different deficiency syndrome groups: the pre-dialysis SBPCV of patients in the Yin and Yang Deficiency Syndrome group was higher than that of Spleen and Kidney Qi Deficiency,Spleen and Kidney Yang Deficiency,and Liver and Kidney Yin Deficiency Syndromes.SBPCV before and during dialysis of patients in the Qi and Yin Deficiency Syndrome was higher than that of Spleen and Kidney Yang Deficiency and Yin and Yang Deficiency(p <0.05).Ⅳ.Among the different excessive syndrome groups: The SBPCV in dialysis of patients with Water-qi Syndrome was higher than that of Blood Stasis Syndrome,Damp-turbidity Syndrome and Damp-heat Syndrome(p <0.05).ConclusionⅠ.The influencing factors of BPV in MHD patients included age,dialysis age,diabetes,weight gain coefficient,i PTH and Alb.The BPV was positively correlated with age,diabetes,weight gain coefficient and i PTH,and was negatively correlated with dialysis age and Alb.Ⅱ.There were differences in BPV among MHD patients with different syndromes.The SBPV before and in dialysis of the Yin and Yang Deficiency Syndrome and Qi and Yin Deficiency Syndrome were higher than those of patients with Spleen and Kidney Qi Deficiency,Spleen and Kidney Yang Deficiency,and Liver and Kidney Yin Deficiency.The SBPV in dialysis of patients with Water-qi Syndrome was higher than that of patients with other excessive syndromes.