含糖透析液对糖尿病肾病血液透析患者血压和心率变异性的影响

The Influence of Blood Pressure and Heart Rate Variability in Diabetic Nephropathy Patients Received with Glucose Containing Dialysate

目的研究含糖透析液对糖尿病肾病(DN)患者血液透析(HD)中血压和心率变异性(HRV)的影响。方法选取92例接受HD治疗的DN患者,按透析液是否含糖分为:研究组(含糖透析液)45例与对照组(不含糖透析液)47例。比较两组间在透析前、中、后收缩压(SP)、舒张压(DP)、平均血压(MBP)及血糖(GLU)水平的差异。HRV时域指标(低频谱、高频谱)与频域指标(SDNN、PNN50)的差异。结果与对照组相比,研究组透析前SP、DP、MBP及GLU无统计学意义(P>0.05),但透析中、后SP、DP、MBP及GLU较高(P<0.01);研究组高频谱与PNN50无统计学意义(P>0.05),而低频谱与SDNN降低(P<0.01)。结论含糖透析液对DN患者HD中血压和HRV影响小,不过度激活交感神经。

Objective To investigate the influence of glucose containing dialysate（GD） on incidences of blood pressure（BP）and heart rate variability （ HRV ） in diabetic nephropathy patients （ DN ）. Methods A total of 92 hemodialysis patients with DN were divided into two groups, research group received with GD, 45 cases, and control group received with non-GD 47 cases according to dialysis fluid content. The systolic pressure （ SP ）, diastolic pressure （ DP ）, mean blood pressure（MBP） and blood glucose （ GLU ） at pre-, mid-, pos-themodialysis session were compared betweeti two groups. And HR~ time-domain indexs （ low frequency, high frequency ） and frequency-domain indexs （ SDNN, PNN50 ） were also compared in both groups. Results Compared to control group, the SP, DP, MBP and GLU at prehemodialysis session in research group were no difference （ P 〉 0.05 ）, and the above indexes at mid- and post- hemodialysis session in research group were lower （ P 〈 0.01 ）. The high frequency and PNNS0 were no difference in both groups （ P 〉 0.05 ）, and the low frequency and SDNN in research group were lower than those in control group （ P 〈 O.01 ）. Conclusion The influence of GD on incidences of blood pressure and HRV in DN patients and on inducing hyperactivity of sympathetic nerve system was lOW.