不同钠离子浓度透析液对维持性血液透析患者透析前后血清钠离子及钾离子的影响

Effect of dialysate with different sodium ion concentrations on serum sodium and potassium ions in maintenance hemodialysis patients before and after di⁃alysis

目的观察血液透析患者使用不同钠离子浓度的透析液(dialysate sodium concentration,DSC)对维持性血液透析患者透析前后血清钠离子、钾离子的影响。方法选择2022年8月~2023年2月哈尔滨医科大学附属第一医院血液净化中心维持性血液透析患者70例作为研究对象,分为两组:低DSC组38例,透析液钠浓度采用137 mmol/L;高DSC组32例,钠浓度采用140 mmol/L;规律透析治疗3个月。观察比较两组患者的基本资料和DSC影响透析患者相关指标情况。结果两组患者在年龄、性别、透析龄、干体重方面差异均无显著性差异(P>0.05)。低DSC组患者试验后血清钠离子浓度较试验前显著降低(P<0.05),而高DSC组试验前后血清钠离子浓度无显著性差异(P>0.05)。两组患者试验后血清K+与试验前比较无显著性差异(P>0.05)。低DSC组试验前最长透析间隔的透析间期体重增加显著低于高DSC组(P<0.05)。治疗过程中,低DSC组患者透析中低血压发生率显著低于高DSC组(P<0.05),而在肌肉痉挛、头痛和口渴的发生率上,两组无明显差异(P>0.05)。结论与高DSC透析液相比,低DSC透析液能显著降低患者血钠水平,但并不会对患者血钾水平产生影响。

Objective To observe the effects of dialysate sodium concentration(DSC)on ser⁃um sodium and potassium ions in maintenance hemodialysis patients before and after dialysis.Methods A total of 70 patients undergoing maintenance hemodialysis at the Blood Purification Center of the First Affiliated Hospital of Harbin Medical University from August 2022 to Febru⁃ary 2023 were selected as the study subjects.They were randomly divided into two groups:the low DSC group(n=38),with a sodium concentration of 137 mmol/L in the dialysis fluid;The sodium concentration in the high DSC group(n=32)was 140 mmol/L;Regular dialysis treat⁃ment was performed for 3 months.The basic information of two groups of patients and the relat⁃ed variables of DSC affecting dialysis patients were observed and compared.Results There was no significant difference in age,gender,dialysis age,and dry weight between the two groups of patients(P>0.05).The serum sodium ion concentration of patients in the low DSC group decreased significantly after the experiment compared to before(P<0.05),while there was no significant difference in serum sodium ion concentration before and after the experiment in the high DSC group(P>0.05).There was no significant difference in serum K ions be⁃tween the two groups of patients after and before the experiment(P>0.05).The weight gain during the longest dialysis interval before the trial in the low DSC group was significantly lower than that in the high DSC group(P<0.05).During the treatment,the incidence of hypoten⁃sion during dialysis was significantly lower in the low DSC group than in the high DSC group(P<0.05),while there was no significant difference in the incidence of muscle spasms,head⁃ache,and thirst between the two groups(P>0.05).Conclusion Compared with high DSC dialysate,low DSC dialysate can significantly reduce the patients’serum sodium level,but it does not have an impact on the patients’serum potassium level.