不同血液净化方式对维持血透患者高血压的影响  

The Influence of Different Ways of Blood Purification on High Blood Pressure of Patients with Hemodialysis Maintenance

作　　者：李文宏[1] 王煜[1] 陈浩[1] 殷玉敏[1] 杜萍[1] 刘军平[1] 

机构地区：[1]昆明医科大学附属延安医院,云南昆明650051

出　　处：《昆明医科大学学报》2015年第3期68-71,共4页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金资助项目(20100092)

摘　　要：目的探讨四种不同血液净化方式对维持血透(MHD)患者高血压影响的优劣情况.方法选取MHD并高血压患者80例,随机分为4组(常规血透组、S-HDF组、S-HP组、S-HFP组),比较治疗3、6周后收缩压(SBP)、降压达标率(BPCR)、血肌酐(Scr)、尿素氮(BUN)、甲状旁腺素(PTH)、C-反应蛋白(CRP)、血红蛋白(HGB)、血小板(Plt)及降压药减量情况.结果治疗3周、6周后S-HDF组、S-HP组、S-HFP组与治疗前及常规血透组比SBP、PTH、CRP均下降(P<0.05),BPCR增高(P<0.05);S-HP组、S-HFP组Scr、BUN较治疗前、常规血透组、S-HDF组下降明显(P<0.05),试验组各组与常规血透组比较降压药减量人数在治疗3周、6周后均增多(P<0.05).结论 S-HDF、S-HP、S-HFP能有效控制MHD患者的高血压,尤于S-HFP效果最佳,其机制可能与规律、定期应用血液净化清除高血压致病因子有关.Objective To research the pros and cons of four different blood purification modes on hypertension of maintenance hemodialysis（MHD） patients. Methods 80 MHD patients with high blood pressure, were randomly divided into 4 groups： Regular hemodialysis group, S-HDF group, S-HPgroup, and S-HFP group. Then we compared the systolic blood pressure（SBP）,blood pressure control rate（BPCR）, serum creatinine（Scr）, blood ureanitrogen（BUN）, parathyroidhormone（PTH）, C-reactiveprotein（CRP）,hemoglobin（HGB）, platelet（Plt） and reduction of hypotensive drugs 3 and 6 weeks after treatment. Results SBP, PTH and CRP dropped（P〈0.05） in S-HDF group, S-HP group, S-HFP group 3 and 6 weeks after treatment compared with before treatment and regular hemodialysis group, BPCR increased（P〈0.05）. Scr,BUN in S-HP group and S-HFP group dropped obviously compared with before treatment, regular hemodialysis group and S-HDF group（P〈0.05）,the number of reduction of hypotensive drugs 3 and 6 weeks after treatment increased compared with all experimental groups and regular hemodialysis group（P〈0.05）. Conclusions Hypertension of MHD patients could be controlled and maintained effectively by S-HDF, S-HP and S-HFP,especially S-HFP, its mechanism may be related with removing the pathogenic factors of hypertension by using blood purification regularly and termly.

关 键 词：血液净化 维持血透 高血压 临床疗效 

分 类 号：R532.1[医药卫生—内科学]