| 摘要: |
| ［摘要］ 目的 观察血液灌流对维持性血液透析患者血压和致高血压物质的影响。方法 将60例符合难治性高血压的维持性血压透析患者随机分为灌流组及对照组，分别在血液透析基础上进行血液灌流和透析滤过治疗。观察两组治疗前后血压 、降压药使用、血肾素活性（PRA）、内皮素(ET)、血管紧张素Ⅱ（ATⅡ）、甲状旁腺素(PTH)、醛固酮（Ald）等致高血压物质及血肌酐（Bcr）、磷（P）的变化。结果 伴难治性高血压血透患者存在高水平的PRA、ET 、ATⅡ、PTH、Ald、β2-MG； 16周后，两组Bcr、P、β2-MG、Ald较治疗前明显降低，差异有统计学意义（P<0.05）；灌流组ATⅡ、ET较治疗前明显降低，差异有统计学意义（P<0.05），而对照组无明显变化；两组PTH 均有明显下降，灌流组P<0.01，对照组P<0.05；两组PRA治疗前后无明显变化。灌流组血压下降，降压药种类使用减少，治疗前后差异有统计学差异。对照组血压及降压药使用种类有下降趋势，但治疗前后差异无统计学意义。结论 灌流组对致高血压物质的清除优于对照组，有明显降低血压的作用。 |
| 关键词: 血液灌流 血液透析滤过 尿毒症 难治性高血压 |
| DOI：10.3969/j.issn.1674-3806.2009.07.08 |
| 分类号:R 544.1 |
| 基金项目:广西壮族自治区卫生厅自筹经费科研课题（桂卫Z2005136） |
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| Effects of hemoperfusion on refractory hypertension in hemodialysis patients |
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ZHANG Wen-xin, PENG Xiao-mei, GONG Zhi-feng, et al.
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Department of nephrology, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To observe the effects of hemoperfusion on refractory hypertension and the material caused hypertension in hemodialysis patients. Methods Sixty hemodialysis patients with refractory hypertension were divided into two groups randomly. On the base of hemodialysis, hemoperfusion group was given hemoperfusion; control group was given hemodiafiltration. The blood pressure 、PRA、ET、ATⅡ、PTH、Ald were observed.Results Two groups had high level of PRA、ET 、ATⅡ、PTH、Ald. 16 weeks later, Bcr、P、β2-MG、Ald were significant decreased in both groups(P<0.05); ATⅡ、ET were significantly decreased in hemoperfusion group(P<0.05); the level of PTH in hemoperfusion group was significantly lower in hemoperfusion group(P<0.01), and in control group(P<0.05). The blood pressure and medicines were significantly decreased in hemoperfusion group.Conclusion Hemoperfusion treatment had good effects on cleaning material caused hypertension and decreasing hypertension. |
| Key words: Hemoperfusion Hemodiafiltration Uremia Refractory hypertension |
