血液透析中进餐对老年尿毒症患者血压的影响

Influence on blood pressure for old patients with uraemia by dining during hemodialysis

目的探讨老年尿毒症患者血液透析中进餐时血压的变化与意义。方法将20例老年患者与20例非老年患者,按血液透析中进餐与否分为老年进餐组(A组)及老年非进餐组(B组)、非老年进餐组(C组)和非老年非进餐组(D组),比较四组的平均动脉压(MAP)变化并结合血糖(BG)水平进行分析。结果低血压发生率:A组(304/740,41.08%)>B组(223/740,30.14%),C组(213/740,28.78%)>D组(145/740,19.59%),B、C两组比较差异无统计学意义;A组伴低血糖(28例次)MAP明显高于无低血糖(276例次);B组伴低血糖(35例次)的MAP与无低血糖(188例次)相当。结论在血透中进餐可能增加症状性低血压的发生率,尤以老年尿毒症患者为甚,在血液透析中伴低血糖的ESDN患者更易发生低血压。

Objective To investigate the change and significance of blood pressure for old patients（ ≥ 60 years old） with uraemia by dining during hemodialysis. Methods All of 20 old patients were randomly divided into dinner group （A）, no diner group （B） during the courses of hemodialysis, and 20 patients （〈60 years old） were divided into diner group C and no diner group D. The change of MAP was observed and compared among the four groups combined with BG level. Results The accident rate of hypertension of group A （304/740, 41.08%） 〉group B （223/740,30.14%）, C group （213/740, 28.78%） 〉group D （145/740, 19.59%） （P 〈 0.05）. There was no significant difference between group C and group B.MAP of group A with lower BG accidence （28 cases） were significant higher than that of group A without BG accidence （276 eases）.There was no significant in MAP between 35 cases with lower BG accidence and 188 cases without lower BG accidence. Conclusion The dinning during the courses of hemodialysis may increase the accidence rate of symptomatic hypotension, especially for old patients with uraemia. Hypertension is more likely to be observed among old patients with lower BG accidence during hemodialysis.