水盐摄入限制对腹膜透析患者血容量及血压的影响  

Effect of Salt and Water Restriction on Fluid Status and Blood Pressure in Continuous Ambula- tory Peritoneal Dialysis Patients

作　　者：赵黎佳[1] 杜凤和[1] 龚勇[1] 

机构地区：[1]首都医科大学附属北京天坛医院心肾内科,北京100050

出　　处：《医学临床研究》2010年第2期254-255,258,共3页Journal of Clinical Research

摘　　要：【目的】探讨限制水盐摄入对腹膜透析患者血容量和血压的影响。【方法】对41例接受连续性不卧床腹膜透析（CAPD）治疗至少3个月的患者，在不增加高渗腹膜透析液的前提下，指导患者限制饮食中水盐摄入。采用自身前后对照的方法，检测并评估水盐限制前后水肿程度、体重、容量负荷、血压、尿量和超滤量等变化。【结果】水盐限制后，患者水肿程度减轻，体重由（61．7±9．1）kg减至（60．6±8．6）kg，收缩压由（137．3±22．9）mmHg降至（133．4±23．6）mmHg，总体液（TBW）、细胞外液（ECW）、细胞内液（ICW）、总液体清除量均有显著降低，差异具有统计学意义（P〈0．05）；降压药种类（1．5±1．2比1．2±1．1，P=0．054）及透析液总剂量[（7956．4±1183．8）ml。比（7651．3±1313．7）mL，P=0．062]有减少倾向，但未达统计学意义；24h尿量在水盐限制前后无明显改变（P〉0．05）。【结论】单纯限制饮食中水盐摄入可改善容量超负荷状态，并降低血压。限制水盐摄入是CAPD患者控制高血压的重要因素。[Objective]To study the effect of salt and water restriction on fluid status and blood pressure in continuous ambulatory peritoneal dialysis （CAPD） patients. [Methods] Forty one patients treated with CAPD for at least 3 months were advised to take salt and water restriction without adding hypertonic peritoneal dialysis solutions. By own control, the edema, body weight, volume load, blood pressure, urine volume and ultra filtration volume were measured and evaluated before and after taking salt and water restriction. [Results] After taking salt and water restriction, edema was relieved, and body weight decreased from（61.7 ± 9.1） kg to （60.6±8.6）kg, and systolic pressure reduced from （137.3±22.9）mmHg to（133.4±23.6）mmHg. Total body water （TBW）, extracellular water （ECW）, intercellular water （ICW） and total fluid removal were sig nificantly decreased, and the difference had statistical significance （ P 〈0.05）. The number of antihypertensivedrug （1.5±1.2 vs. 1.2±1.1, P =0. 054）. and dialysate doses （7956.4± 1183.8ml vs. 7651.3±1313.7 mL, P =0. 062） had the tendency of reduction, but there was no statistical significance. The urine volume did not change significantly（ P 〉0.05）. [Conclusion] Salt and water restriction only in diet can improve the vol ume overload and decrease the blood pressure. It is important to control the blood pressure of CAPD patients.

关 键 词：腹膜透析 血压 

分 类 号：R459.5[医药卫生—治疗学]