血液灌流联合常规血液透析治疗维持性血液透析伴长期高血压(1)
[摘要] 目的 对维持性血液透析(MHD)伴长期高血压患者，行以血液灌流(HP)联合常规血透(HD)的血液净化治疗，动态观察患者的血压情况。方法 方便择选2017年9月—2018年9月该院收治的90例持续性血液透析伴长期高血压患者，根据血液净化模式差异，分为常规血透组(HD组)和常规血透联合血液灌流组(HD+HP组)，每组45例患者，选择30例慢性肾脏病患者设置为对照组。分别在测定治疗前以及治疗4、8、12周4个阶段，测量患者的24 h动态血压、血浆内皮素-1(ET-1)和血清瘦素(Lep)水平，并进行科学对比。结果 治疗前，HD组患者与HD+HP组患者各项指标差异无统计学意义(P>0.05)。分别对比治疗前HD+HP组患者和治疗12周HD组患者与治疗12周HD+HP组患者和对照组患者各项指标可以发现，血浆内皮素-1(ET-1)和血清瘦素(Lep)均处于相对较高的水平，同时收缩压偏高、舒张压偏高，差异有统计学意义(P<0.05)。对比治疗12周HD+HP组患者与对照组患者相关指标可以发现，治疗12周HD+HP组患者的血浆内皮素-1(ET-1)和舒张压分別为(104.91±11.58)pg/mL、(90.62±10.54)mmHg，对照组分别为(49.5±7.03)pg/mL、(82.34±10.53)mmHg，两组指标比较差异有统计学意义(t=54.126、10.367，P<0.05)，而血清瘦素(Lep)和收缩压的差异无统计学意义(P>0.05)。 结论 对MHD伴长期高血压患者行以HP联合HD的复合血液净化治疗方法，可在合理使用降压药物的基础上，长期控制患者血压在相对理想的水平范围。
[关键词] 血液灌流;常规血透;维持性血液透析;高血压
[中图分类号] R459.5 [文献标识码] A [文章编号] 1674-0742(2019)08(a)-0001-03
[Abstract] Objective To maintain the blood pressure of patients with maintenance hemodialysis (MHD) with long-term hypertension by blood perfusion (HP) combined with conventional hemodialysis (HD). Methods Ninety patients with persistent hemodialysis and long-term hypertension admitted to our hospital from September 2017 to September 2018 were conveniently selected. According to the difference of blood purification models， they were divided into routine hemodialysis group (HD group) and routine hemodialysis combined with blood. In the perfusion group (HD+HP group)， 45 patients in each group， 30 patients with chronic kidney disease were selected as the control group. The 24h ambulatory blood pressure， plasma endothelin-1 (ET-1) and serum leptin (Lep) levels were measured before and after treatment， and at 4， 8， and 12 weeks of treatment， and scientific comparisons were made. Results Before treatment， there was no statistically significant difference between the HD group and the HD+HP group(P>0.05). Comparing the indicators of the pre-treatment HD+HP group and the 12-week HD group and the 12-week HD+HP group and the control group， plasma endothelin-1 (ET-1) and serum leptin (Lep)were observed was at a relatively high level， and the systolic pressure was high and the diastolic blood pressure was high. The difference was statistically significant(P<0.05). Comparing the 12-week HD+HP group with the control group， the plasma endothelin-1 (ET-1) and diastolic blood pressure were (104.91±11.58)pg/mL in the 12-week HD+HP group， (90.62±10.54) mmHg， the control group was (49.5±7.03) pg/mL， (82.34±10.53) mmHg， the difference between the two groups was statistically significant (t=54.126， 10.367， P<0.05). There was no statistically significant difference in serum leptin (Lep) and systolic blood pressure (P>0.05). Conclusion For patients with MHD with long-term hypertension， the combined blood purification treatment method of HP combined with HD can control the blood pressure of patients in a relatively ideal range on the basis of rational use of antihypertensive drugs., 百拇医药(王攀)
[关键词] 血液灌流;常规血透;维持性血液透析;高血压
[中图分类号] R459.5 [文献标识码] A [文章编号] 1674-0742(2019)08(a)-0001-03
[Abstract] Objective To maintain the blood pressure of patients with maintenance hemodialysis (MHD) with long-term hypertension by blood perfusion (HP) combined with conventional hemodialysis (HD). Methods Ninety patients with persistent hemodialysis and long-term hypertension admitted to our hospital from September 2017 to September 2018 were conveniently selected. According to the difference of blood purification models， they were divided into routine hemodialysis group (HD group) and routine hemodialysis combined with blood. In the perfusion group (HD+HP group)， 45 patients in each group， 30 patients with chronic kidney disease were selected as the control group. The 24h ambulatory blood pressure， plasma endothelin-1 (ET-1) and serum leptin (Lep) levels were measured before and after treatment， and at 4， 8， and 12 weeks of treatment， and scientific comparisons were made. Results Before treatment， there was no statistically significant difference between the HD group and the HD+HP group(P>0.05). Comparing the indicators of the pre-treatment HD+HP group and the 12-week HD group and the 12-week HD+HP group and the control group， plasma endothelin-1 (ET-1) and serum leptin (Lep)were observed was at a relatively high level， and the systolic pressure was high and the diastolic blood pressure was high. The difference was statistically significant(P<0.05). Comparing the 12-week HD+HP group with the control group， the plasma endothelin-1 (ET-1) and diastolic blood pressure were (104.91±11.58)pg/mL in the 12-week HD+HP group， (90.62±10.54) mmHg， the control group was (49.5±7.03) pg/mL， (82.34±10.53) mmHg， the difference between the two groups was statistically significant (t=54.126， 10.367， P<0.05). There was no statistically significant difference in serum leptin (Lep) and systolic blood pressure (P>0.05). Conclusion For patients with MHD with long-term hypertension， the combined blood purification treatment method of HP combined with HD can control the blood pressure of patients in a relatively ideal range on the basis of rational use of antihypertensive drugs., 百拇医药(王攀)