摘要
目的研究传统透析方式中钠清除的特点，探讨患者钠平衡与血压水平的关系。方法随机选取14例维持性血液透析患者，测定透析前、后血钠水平。透析开始及之后每30分钟取20ml超滤废液，9次共180ml，混合后取10ml，估算超滤引起的NaCl清除量以及NaCl的总清除量。按照NaCl清除量的中位数将患者分为2组（≥29g组和〈29g组），采用FishergExactTest对不同组别高血压发生率进行比较。结果单次透析的NaCl清除量为（29±14．9）g，其中超滤的NaCI清除量为（18±6．9）g，占（83±58．6）％。FishergExactTest结果显示，认为每次透析NaCl清除量〈29g的患者更容易发生高血压（≥150／90mmHg）（P=0．023）。结论影响血液透析中钠清除的因素非常复杂。超滤是血液透析NaCl清除的主要方式。对于无尿的患者，传统维持性血液透析模式下保证每周足够的超滤量而不是通过限制水的摄入量才是达到人体钠平衡从而更好的控制血压的方法。
Objective To evaluate the role of the sodium removal and explore the relationship of sodium balance and blood pressure in patients with traditional hemodialysis. Methods Fourteen patients with maintenance hemodialysis were randomly enrolled in this study. Serum sodium concentration was meas- ured at the pre-dialysis and post-dialysis. At the beginning of dialysis and every half hour, 20 ml waste dia- lysates were collected, 10 ml were drown from total 180 ml waste dialysates that had being mingled for meas- uring total NaCI removal and the removal caused by ultrafiltration. The Fisher＇s Exact Test was used to ana- lyze the difference in incidence of hypertension（ ≥ 150/90 mmHg group or 〈 150/90 mmHg） between the different NaC1 removal groups. Results The total NaCI removal in single hemodialysis session was （29 ± 14.9）g, A average of （18 ±6.9）g sodium was removed by ultrafiltation （83 ±58.6）%. The patients whose sodium removal in a hemodialysis session were less than 29 g, which were vulnerable to hypertension （ ≥150/90 mmHg group） （ P =0. 023）. Conclusions The factors that effected sodium removal in hemo- dialysis session were complicated; most of sodium was removed by ultrafiltration of plasma water. These re- sults demonstrated that adequate ultrafiltration volume in triple times a week rather than restriction of fluid intake was the principal factor that controls blood pressure in patients with traditional hemodialysis.
出处
《中国医师杂志》
CAS
2013年第4期472-474,共3页
Journal of Chinese Physician
关键词
肾透析
血压
钠
代谢
血液透析液
Renal dialysis
Blood pressure
Sodium/metabolism
Hemodialysis solutions
