低钠透析联合血液透析滤过在尿毒症伴顽固性高血压治疗中应用研究

Application of low-sodium dialysis combined with hemodiafiltration in treatment of uremia with resistant hypertension

目的:探讨尿毒症伴顽固性高血压采用低钠透析联合血液透析滤过治疗的效果。方法:选取某院收治的尿毒症伴顽固性高血压患者90例,按单盲法分为对照组和观察组,每组各45例。对照组采用血液透析滤过治疗,在此基础上,观察组采用低钠透析治疗,比较2组患者血压水平、心功能及毒性代谢物含量。结果:治疗后,观察组24h平均舒张压(24h DBP)、24h平均收缩压水平(24h SBP)、舒张早期/晚期最大血流速度(E/A)、血尿素氮(BUN)、血肌酐(SCr)、血管紧张素Ⅱ(ATⅡ)水平均较对照组低,心输出量(CO)、每搏量(SV)水平均较对照组高,2组比较差异有统计学意义(P<0.05)。结论:尿毒症伴顽固性高血压患者采用低钠透析联合血液透析滤过治疗可降低血压水平,利于毒性代谢物清除,改善心功能。

Objective :To investigate the effects of low-sodium dialysis combined with hemodiafiltration in treatment of uremia with resistant hypertension. Methods :90 cases of uremia with resistant hypertension admitted in a hospital were selected and were divided into a control group and an observation group by single blind method, with 45 cases in each.The control group was given hemodiafiltration,while observation group was treated with low-sodium dialysis based on the regime of the control group.Blood pressure,cardiac function and toxic metabolite contents were compared between the two groups. Results :AfteRtreatment, the 24h mean diastolic blood pressure (24h DBP), 24h mean systolic blood pressure (24h SBP), mitral early and late diastolic peak velocity ratio (E/A), blood urea nitrogen (BUN), serum creatinine (SCr), and angiotensin II (ATⅡ) in the observation group were loweRthan those in the control group, while cardiac output (CO) and stroke volume (SV) in the observation group were higheRthan those in the control group, the difference being statistically significant ( P <0.05). Conclusion : Low-sodium dialysis combined with hemodiafiltration in treatment of uremia with resistant hypertension can decrease the level of blood pressure, help the elimination of toxic metabolite contents and improve cardiac function.