腹膜透析患者容量控制对血压的影响  

Relationship between volume and blood pressure in patients with peritoneal dialysis

作　　者：王瑞敏[1] 马岩[1] 胜彦婷[1] 赵黎佳[1] 杜凤和[1] 汪涛[2] 

机构地区：[1]首都医科大学附属北京天坛医院,北京100050 [2]北京大学第一医院肾内科京大学肾脏病研究所

出　　处：《临床内科杂志》2005年第8期519-521,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨限制水钠摄入对腹膜透析患者容量负荷及血压的影响。方法对45例腹膜透析患者,实行限制水钠摄入治疗2个月,测量患者治疗前后的体重、体液容量及血压等相关资料。结果治疗后,33例患者体重减轻(1.9±1.4)kg,细胞外液(ECW)减少(1.20±0.81)L,收缩压(SBP)降低(9.2±14.3)mmHg,差异均有显著性(P<0.01);患者体力、睡眠、饮食等自我感觉改善。另12例患者体重增加(1.2±1.2)kg,ECW增加(0.55±1.09)L,收缩压升高(2.8±10.6)mmHg。治疗前患者收缩压与nECW可能有直线相关关系(r前=0.285,P=0.058);治疗后则显著相关(r后=0.359,P=0.017),还受抗高血压药物治疗的影响(r后=0.334,P=0.027);各因素变化量之间存在直线相关关系。结论腹膜透析患者中,体液容量与血压间存在正相关关系。严格限制患者水钠摄入可以有效控制容量过度负荷,从而控制血压。Objective To investigated the relationship between volume overload and hypertension in patients with continuous ambulatory peritoneal dialysis （CAPD） and effect of dietary salt restriction on blood pressure control. Methods The intake of fluid and salt in stable CAPD patients was restricted for 2 months. Their body weight, extracellular water （ ECW ）, intracellular water （ ICW ）, total body water （TBW） , blood pressure, urine volume and ultrafiltrate volume were measured before and after the dietary restriction. Results Forty-five CAPD patients were enrolled. After dietary salt restriction, significant deceases in body weight （ 1.9 ± 1.4 kg,P 〈 0.001 ）, ECW （ 1.20 ± 0.81L,P 〈 0. 001 ） and systolic blood pressure （9.2 ± 14.3 mm Hg,P 〈0.01 ） were seen in 33 patients whereas the opposite changes were seen in the remaining 12 patients. A significant correlation was found between systolic blood pressure and nECW after two months of dietary restriction （ rpost =0.359 ,P =0. 017） and between the changes in blood pressure and changes in fluid volume. Conclusions There is a positive correlation between volume status and blood pressure. Most of the CAPD patients are fluid overloaded and that dietary salt restriction may be an effective way to control volume and blood pressure. However,the compliance of patients to dietary salt restriction can influence the effect.

关 键 词：持续性非卧床腹膜透析 容量超负荷 水钠限制 血压 

分 类 号：R459.5[医药卫生—治疗学]