血液灌流联合血液透析治疗肾功能衰竭难治性高血压的效果

Effect of Hemoperfusion Combined with Hemodialysis on Refractory Hypertension with Renal Failure

目的探讨血液灌流联合血液透析对肾功能衰竭难治性高血压的治疗效果。方法选取2017年10月~2019年2月我院收治的肾功能衰竭难治性高血压患者168例,随机分为对照组和研究组,每组84例。对照组应用血液透析治疗,研究组应用血液灌流联合血液透析治疗,比较两组治疗前后血压改善情况、肾素(PRA)、血管紧张素Ⅱ(ATⅡ)水平变化。结果治疗后,两组收缩压、舒张压、平均动脉压均低于治疗前,差异有统计学意义(P<0.05);研究组收缩压、舒张压、平均动脉压均低于对照组[(145.37±14.54)mmHgvs(185.25±18.46)mmHg]、[(76.26±5.72)mmHgvs(107.51±9.27)mmHg]、[(100.47±9.39)mmHgvs(143.52±11.74)mmHg],差异有统计学意义(P<0.05)。治疗后,两组PRA、ATⅡ水平均低于治疗前,差异有统计学意义(P<0.05);研究组PRA、ATⅡ水平低于对照组[(1.05±0.36)ng/Lvs(1.88±0.57)ng/L]、[(91.31±13.47)ng/Lvs(170.54±20.66)ng/L],差异有统计学意义(P<0.05)。结论血液灌流联合血液透析治疗肾功能衰竭难治性高血压效果理想,可有效控制高血压症状,改善患者PRA、ATⅡ水平。

Objective To investigate the therapeutic effect of hemoperfusion combined with hemodialysis on refractory hypertension with renal failure.Methods A total of 168 patients with renal failure and refractory hypertension admitted to our hospital from October 2017 to February 2019 were randomly divided into the control group and the study group,with 84 cases in each group.The control group was treated with hemodialysis. The study group was treated with hemoperfusion combined with hemodialysis.The blood pressure improvement,renin(PRA)and angiotensin Ⅱ(ATⅡ)levels were compared before and after treatment.Results After treatment,the systolic blood pressure,diastolic blood pressure and mean arterial pressure were lower than those before treatment,the difference was statistically significant(P<0.05).The systolic,diastolic,and mean arterial pressures of the study group were lower than those of the control group[(145.37±14.54)mmHg vs(185.25±18.46)mmHg],[(76.26±5.72)mmHg vs(107.51±9.27)mmHg],[(100.47±9.39)mmHg vs(143.52±11.74)mmHg],the difference was statistically significant(P<0.05).After treatment,the levels of PRA and ATII in the two groups were lower than those before treatment,the difference was statistically significant(P<0.05).The level of PRA and ATII in the study group was lower than that in the control group[(1.05±0.36)ng/L vs(1.88±0.57)ng/L],[(91.31±13.47)ng/L Vs(170.54±20.66)ng/L],the difference was statistically significant(P<0.05).Conclusion Hemoperfusion combined with hemodialysis is effective in the treatment of refractory hypertension with renal failure.It can effectively control the symptoms of hypertension and improve the levels of PRA and ATII.