低钠、低钙透析对尿毒症患者透析中高血压干预的临床观察  

Clinical effect of low-sodium and low-calcium dialysis on intradialytic hypertension of maintenance hemodialysis patients

作　　者：蒲超[1] 白佳柠 陈永忠[1] 朱再志 许志忠[1] 

机构地区：[1]四川省眉山市人民医院肾内科,四川眉山620010

出　　处：《中国现代医学杂志》2016年第18期128-130,共3页China Journal of Modern Medicine

摘　　要：目的观察低钠联合低钙透析对尿毒症患者透析中发生高血压干预的临床效果。方法选取2009年4月-2015年4月在四川省眉山市人民医院行维持性血液透析的48例在透析中发生高血压的患者为研究对象(在透析过程中平均动脉压升高>15 mmHg即可诊断为透析中高血压)。所有患者给予低钙透析(1.25 mmol/L)和低钠透析(Na^+135 mmol/L)。分别测量治疗前及透析中1 h、2 h、3 h和4 h收缩压、舒张压,计算平均动脉压(每次透析的收缩压、舒张压和平均动脉压为平均值);每周检测患者血浆钠、钙浓度;每月检测全段甲状旁腺素浓度。结果在治疗8周后,患者收缩压和舒张压较前均显著下降(P<0.01);治疗前后钠、钙和全段甲状旁腺素浓度无明显改变(P>0.05);无不良反应发生。结论低钠、低钙透析对在透析中发生高血压有显著的治疗效果,且无不良事件发生。Objective To observe the intervention effect of low-sodium and low-calcium dialysis on intradialysis hypertension （IDH） of maintenance hemodialysis （MHD） patients. Methods Forty-eight cases who had IHD during MHD in our blood purification center from April 2009 to April 2015 were selected as the research subjects. All the participants were given the treatment of low-sodium （135 mmol/L） and low-calcium （1.25 mmol/L） dialysis. Systolic blood pressure （SBP） and diastolic blood pressure （DBP） were measured before treatment, 1, 2, 3 and 4 hours after the beginning of dialysis, and the mean arterial blood pressure （MAP） was calculated according to SBP and DBP. Serum levels of sodium and calcium were surveyed and analyzed every week after treatment; intact parathyroid hormone （iPTH） level was monitored each month. Results The SBP and DBP significantly decreased 8 weeks after therapy compared with those before treatment （P〈0.05）. But the concentrations of Na＋, Ca2＋, and iPTH were not obviously changed after treatment （P〉0.05）. There was no adverse reaction. Conclusions Low-sodium and low-calcium dialysis has obvious effect on IDH of MHD patients.

关 键 词：低钠透析 低钙透析 透析中高血压 

分 类 号：R459.5[医药卫生—治疗学]