不同血液净化治疗方法对终末期肾病难治性高血压患者的临床观察  

The clinical observation of different blood purification treatment to refractory hypertension in end stage renal disease

作　　者：程新[1] 袁一孟[2] 黄仁发[1] 赖申昌[1] 马晓露[1] 吴潇云[1] 

机构地区：[1]广西中医学院附属瑞康医院肾内科,南宁530011 [2]四川省自贡市第一人民医院肾内科

出　　处：《国际移植与血液净化杂志》2012年第6期16-18,共3页International Journal of Transplantation and Hemopurification

摘　　要：目的不同血液净化方法治疗维持性血液透析患者难治性高血压的疗效观察。方法60例终未期肾病难治性高血压患者按随机数字表法分为血液透析组，血液透析联合血液透析滤过组，血液透析联合血液灌流组，每组15例患者。血液透析联合血液透析滤过再联合血液灌流组，观察治疗前及治疗16周后所有患者血压变化及。肾素、血管紧张素Ⅱ、全段甲状旁腺激素的水平变化。结果各组患者治疗后血压及肾素、血管紧张素Ⅱ、全段甲状旁腺激素水平与治疗前比较差异有统计学意义（P〈0．05），而治疗组中血液透析联合血液透析滤过再联合血液灌流组与血液透析联合血液灌流组、血液透析联合血液透析滤过组治疗后比较，血压变化及肾素、血管紧张素Ⅱ、全段甲状旁腺激素水平与治疗前比较差异有统计学意义（P〈0．05）。结论在维持血液透析的治疗基础上联合应用血液透析滤过及血液灌流能有效的控制终未期肾病难治性高血压。Objective To investigate the treatment effect of various blood purification methods in combination therapy in hemodialysis patients with refractory hypertension. Methods 60 patients with end stage renal disease refractory hypertension were randomly divided into 4 groups： control group, the hemodia- lysis group （HD）, treatment group were divided into 3 groups： combined Hemodialysis hemodiafiltration group （HD ＋ HDF）, blood dialysis on blood perfusion group （HD ＋ HP）, blood dialysis and hemodiafiltration and then combined blood perfnsion group （ HD ＋ HP ＋ HP）, Observe before treatment and after 8 weeks of treatment blood pressure and rennin-angiotensin （RA）, angiotensin （ Ang Ⅱ ）, Intact parathyroid hormone （iPTH） level. Results Before treatment, the observation indexes were no significant differences control group and treatment group, before and after treatment showed significant change both in the observation inde- xes, blood pressure and RA, AngⅡ, iPTH levels were significantly decreased （ P 〈 0. 05）. the three treatment groups compared with the control group blood pressure and AngⅡ , iPTH levels were significantly decreased （P 〈 0.05）, in the treatment group HD ＋ HDF ＋ HP group and HD ＋ HP group, HD ＋ HDF group after treatment compared, blood pressure and RA, Ang Ⅱ , iPTH levels were significantly decreased （P 〈 0.05）. Conclusions Based on the maintenance of the treatment of hemodialysis combined hemodiafiltration and blood perfusion can effectively control refractory end stage renal disease hypertension.

关 键 词：血液透析 血液透析滤过 血液灌流 终未期肾病 难治性高血压 

分 类 号：R692.5[医药卫生—泌尿科学]