血液透析对糖尿病患者血糖的影响  

The effect of hemodialysis on plasma glucose in diabetic patients

作　　者：刘东[1] 伦立德[1] 张赤兵[1] 白玲[1] 李宁军[1] 杨爱军[1] 

机构地区：[1]解放军空军总医院肾病科,北京100036

出　　处：《中国血液净化》2005年第12期663-664,679,共3页Chinese Journal of Blood Purification

摘　　要：目的探讨血液透析(HD)对糖尿病患者血糖的影响。方法14例糖尿病及26例非糖尿病慢性肾功能衰竭患者,均采用标准碳酸氢盐无糖透析液进行血液透析。于餐后立即开始HD治疗,HD期间不进食,分别于透析0h、1.0h、2.0h、3.0h、4.0h、4.5h检测血糖;于第2次透析2.5h静脉推注30g葡萄糖,HD结束前检测血糖。结果有11/14例糖尿病患者和10/26非糖尿病患者HD期间血糖低于3.5mmol/L(P<0.05),在21例出现低血糖的患者中10例无任何自觉症状;出现低血糖者具有年龄偏大的特点(P<0.05)但是性别、体重指数、血浆白蛋白水平差异无显著性(P>0.05)。于透析2.5h给予30g葡萄糖后,HD结束时未出现低血糖,也无血糖明显增高。结论HD过程中容易出现低血糖,糖尿病及高龄患者在HD过程中更易发生低血糖,于透析2.5h给予30g葡萄糖可以防止低血糖的发生。Objective To assess the effect of hemodialysis on plasma glucose in diabetic patients. Methods 14 diabetic patients and 26 non diabetic patients with chronic renal failure were hemodialyzed using standard glucose-free dialysis fluid. They eated prior to dialysis and were asked not to eat during hemodialysis. Blood glucose of 0h, l.0h, 2.0h, 3：0h, 4.0h, 4.5h were measured at regular intervals during dialysis. During the second HD session, 30g glucose was provided at 2.5h. ResultsPlasma glucose fell below 3. 5mmol/1 in 11 of 14 diabetic patients and 10 of 26 non diabetic patients（P〈0.05）.In the group of patients whose plasma glucose fell below 3. 5mmol/l, no symptom of hypoglycemia were shown in 10 of the 21 patients. The patients occulted hypoglycemia were older（P〈0.05）. There was no significant difference between the hypoglycemic and non-hypoglycemic groups for sex, BMI, serum albumin（P〉0.05）. After 30g glucose provided at 2.5h, there were not occulted hypoglycemia and hyperglycemia. Conclusions Patients undergoing hemodialysis may become hypoglycemia. Diabetic patients and older patients were prone to occulting hypoglycemia. Hypoglycemia may be prevented by infusing 30g glucose at 2.5h.

关 键 词：血液透析 低血糖 糖尿病 

分 类 号：R318.16[医药卫生—生物医学工程] R459.5[医药卫生—基础医学]