强化超滤对老年维持性血液透析患者高血压的影响VIP免费

·293·中国血液净化2012年6月第11卷第6期ChinJBloodPurif,June,2012,Vol.11,No.6·临床研究·强化超滤对老年维持性血液透析患者高血压的影响邓英辉王君梅林娜贾强【摘要】目的观察通过强化超滤以进一步降低干体质量对老年维持性血液透析患者高血压的影响。方法老年维持性血液透析合并高血压患者34名分为对照组和超滤组。对照组维持常规血液透析及常规超滤。超滤组维持常规血液透析，并持续缓慢增加超滤量，降低干体质量。观察持续28周，比较2组患者干体质量和血压的变化。结果基点处2组患者干体质量基本相同[(64.81±13.26)Kg和(64.49±13.83)Kg，t=0.508，P=0.618]，透析前收缩压[(155.12±13.77)mmHg和(155.47±9.92)mmHg，t=0.086，P=0.932](1mmHg=0.133Kpa)及舒张压[(78.59±11.41)mmHg和(78.71±10.96)mmHg，t=0.031，P=0.976]未见明显差异(P＞0.05)。观察第28周时，2组患者干体重体质量分别为(65.56±13.75)Kg和(62.22±13.34)Kg，较前下降(0.36±1.12)Kg和(2.27±1.03)Kg，超滤组干体质量低于对照组(t=3.785，P=0.002)。透析前收缩压为(155.29±12.73)mmHg和(139.82±4.14)mmHg，分别和较前下降(0.53±4.57)mmHg和(14.29±10.55)mmHg，超滤组收缩压低于对照组(t=4.767，P=0.000)。透析前舒张压分别为(79.12±9.84)mmHg和(68.24±3.57)mmHg，分别较前下降(0.53±4.57)mmHg和(9.00±9.46)mmHg，超滤组舒张压低于对照组(t=4.298，P=0.000)。结论通过强化超滤降低干体质量，有利于老年维持性血液透析患者高血压的控制。【关键词】血液透析；超滤；血压中图分类号：R318.16文献标识码：Adoi:10.3969/j.issn.1671-4091.2012.06.002IntensiveultrafiltrationonhypertensioninelderlyhemodialysispatientsDENGYing-hui,WANGJun-mei,LINNa,JIAQiang.DepartmentofNephrology,BeijingXuanwuHospital,CapitalMedicalUniversity,Beijing100053,ChinaCorrespondingauthor:DENGYing-hui,Email:yinghuideng20046@sina.com【Abstract】ObjectiveToinvestigatewhetheradditionalultrafiltrationtofurtherreducedrybodyweightimprovesbloodpressure(BP)controlamongelderlyhemodialysispatientswithhypertension.Meth-odsThirty-fouragedmaintenancehemodialysis(MHD)patientswithhypertensionweredividedintocontrolandultrafiltrationgroups.Incontrolgroup,conventionaldialysisdoseandultrafiltrationvolumewereused.Inultrafiltrationgroup,reductionofdrybodyweighttoaminimaltolerablelevelwasgraduallyachievedbyslightlyincreasingultrafiltrationvolume.After28weeks,drybodyweightandBPwerecomparedbetweenthetwogroups.ResultsIncontrolgroupandultrafiltrationgroupatthebaselinecondition,drybodyweightwas64.81±13.26kgand64.49±13.83kg(t=0.508,P=0.618),systolicBPwas155.12±13.77mmHgand155.47±9.92mmHg(t=0.086,P=0.932),anddiastolicBPwas78.59±11.41mmHgand78.71±10.96mmHg(t=0.031,P=0.976),respectively,withoutsignificantdifferencesbetweenthetwogroups.Incontrolgroupandultrafiltrationgroupafterthetreatmentfor28weeks,drybodyweightwas65.56±13.75kgand62.22±13.34kg(reducedby0.36±1.12kgand2.27±1.03kg),systolicBPbeforedialysissessionwas155.29±12.73mmHgand139.82±4.14mmHg(reducedby0.53±4.57mmHgand14.29±10.55mmHg),anddiastolicBPbeforedialysissessionwas79.12±9.84mmHgand68.24±3.57mmHg(reducedby0.53±4.57mmHgand9.00±9.46mmHg),respectively.Patientsinultrafiltrationgroupshowedmorereductionindrybodyweight(t=3.785,P=0.002),systolicBP(t=4.767,P=0.000),anddiastolicBP(t=4.298,P=0.000)thanthoseincontrolgroup.ConclusionThedecreaseofdrybodyweightthroughintensiveultrafiltrationisaneffectiveapproachtoimproveBPcontrolinelderlyhemodialysispatientswithhypertension.【Keywords】Hemodialysis;Ultrafiltration;Bloodpressure高血压是维持性血液透析(maintenancehemod-ialysis，MHD)患者的常见合并症。文献报...