下调干体质量对维持性血液透析患者难治性高血压的影响

The influence on refractory hypertension in the maintenance hemodialysis patients by decreasing dry weight

目的观察下调干体质量对维持性血液透析患者难治性高血压的影响。方法对19例难治性高血压患者进行水盐摄入的限制指导,控制透析间期体质量增长。在患者原先设定干体质量基础上,适当增加超滤量,渐降低患者干体质量。直至患者透析前血压≤140/90mmHg,不使用或使用降压药不超过2种;或患者连续2次透析过程中出现症状性低血压或肌肉痉挛。结果研究结束时患者干体质量、收缩压、舒张压及服用降压药种数均明显下降(P<0.05或P<0.01)。干体质量平均下降(3.94±1.03)kg(1.5～6 kg)。结论难治性高血压患者干体质量有较大的下调空间,下调干体质量能明显降低MHD患者高血压。

Objective To observe the influence on refractory hypertension in the maintenance hemodialysis（MHD） patients by decreasing dry weight. Methods Guided the limit of intake of water and salt for nineteen MHD patients to control the inter-dialysis weight gain. Increase ultrafihration volume properly to decrease dry weight of patients until the blood pressure before hemodialysis was lower than 140/90mmHg, and no more than two kinds of hypo-tensors were admitted, or symptomatic hypotension or muscle spasms happened twice continuously during hemodialysis. Results All the dry weight, systolic blood pressure, diastolic blood pressure and the amount of hypo-tensors decreased obviously at the end of study（P 〈 0.05 or P 〈 0.01）. The average dry weight was decreased by （3.94±1.03）kg （1.5-6kg）. Conclusion The dry weight of refractory hypertension patients has more range to decrease and blood pressure of MHD patients can be evidently reduced by decreasing dry weight.