维持性血液透析联合血液灌流对伴有顽固性高血压的尿毒症患者心脏结构和功能的作用  

The protective effect of hemodialysis combined with hemoperfusion on cardiac structure and function for patients undergoing maintenance hemodialysis with resistant hypertension

作　　者：邹懿[1] 王茜茜[1] 程宗华[1] 姚国媛[1] 

机构地区：[1]四川省泸州市人民医院肾脏内科,646000

出　　处：《实用医学杂志》2016年第20期3321-3324,共4页The Journal of Practical Medicine

摘　　要：目的:探讨维持性血液透析(HD)联合血液灌流(HP)对存在顽固性高血压的尿毒症患者左室结构和功能是否具有保护作用。方法:选取在我院规律血液透析合并顽固性高血压的尿毒症患者65例,随机分为联合HD+HP组和常规HD组,随访观察12个月。分别行两组内部的纵向比较和两组间的横向比较,比较指标包括:血压、左心结构和功能及血清炎性指标的变化水平。结果:常规HD组患者的血压及反映左心结构和功能的指标无明显变化,血清炎性指标水平较前升高;HD+HP组患者的血压及反映左室结构和功能的部分指标均有所改善,血清炎性指标水平均显著减低(P<0.05);与常规HD组相比,联合HD+HP组患者心脏结构及功能相关指标明显改善(P<0.05)。结论:HD联合HP与单纯HD相比,可改善有顽固性高血压的终末期尿毒症患者的血压及左室结构和功能。Objective To investigate whether the combination of maintenance hemodialysis（MHD） with hemoperfusion（HP） could improve the left ventricular structure and function of MHD patients with resistant hypertension. Methods This study was a prospective, randomized, controlled clinical trial. 65 MHD patients with resistant hypertension of our hospital were enrolled and then randomly divided into Group HD ＋HP and Group HD. The follow-up study was 12 months. The major outcome measures were related to the cardiac structure and function, and the serum inflammatory factors. Results No statistical differences of related factors such as blood pressure and cardiac function was observed in HD group. The serum concentration of inflammatory factors was higher after one-year HD treatment alone. But the serum concentration of inflammatory related factors,blood pressure, cardiac function and related indexes were lower in HD ＋ HP than in Group HD（P〈0.05）;HD ＋ HP group had higher ejection fraction（EF） and SV, which demonstrated the improved cardiac function（P〈0.05）. Conclusions HD ＋ HP was superior to HD in the treatment in alleviating cardiac after-load and improving the left ventricular structure and function of MHD patients with resistance hypertension.

关 键 词：血液透析 血液灌流 顽固性高血压 心脏结构 

分 类 号：R692.5[医药卫生—泌尿科学] R544.1[医药卫生—外科学]