待肾源移植透析者连续性肾脏替代治疗对顽固性高血压的影响.docVIP

待肾源移植透析者连续性肾脏替代治疗对顽固性高血压的影响 朱? 愿，张晓东，宋? 洁，李? 辉 武警后勤学院附属医院血液净化中心，天津市? 300162 Effects of continuous renal replacement therapy on refractory hypertension in maintenance hemodialysis patients Zhu Yuan, Zhang Xiao-dong, Song Jie, Li Hui Department of Nephrology, Affiliate Hospital of Logistics College of the Chinese People’s Armed Police Forces, Tianjin 300162, China 摘要? 背景：维持性血液透析人群中有10%-49%的患者合并顽固性高血压，常规药物治疗效果差。连续性肾脏替代治疗可较好地清除患者血浆中的中、大分子毒素，理论上可通过降低相关毒素水平干预顽固性高血压形成机制。目的：观察连续性肾脏替代治疗对维持性血液透析患者顽固性高血压的影响。方法：45例维持性血液透析合并顽固性高血压患者，随机分为血液透析组22例与连续性血液净化组23例，血液透析组则行常规血液透析治疗，连续性肾脏替代治疗组在常规血液透析治疗基础上每周行连续性肾脏替代治疗1次。结果与结论：治疗3个月后，连续性血液净化组肾素、内皮素、血管紧张素Ⅱ、C-反应蛋白、白细胞介素6、肿瘤坏死因子α水平均低于试验前水平，24 h平均血压下降，且差异均有显著性意义(P 0.05)，血液透析组上述各指标较试验前无变化(P 0.05)；试验后连续性血液净化组上述各指标均低于血液透析组，差异有显著性意义(P 0.05)。结果显示在常规血液透析基础上行连续性肾脏替代治疗可明显降低合并顽固性高血压维持性血液透析患者的血压，其机制可能是降低了患者血浆中的中、大分子毒素以及炎症因子水平。 中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程 全文链接： 关键词?：?实验动物；?组织构建；?连续性肾脏替代治疗；?顽固性高血压；?血液透析；?肾素；?内皮素；?天津市自然科学基金； ?? Abstract： BACKGROUND: About 10%-49% of maintenance hemodialysis patients are accompanied by refractory hypertension and common drug therapy is ineffective. Continuous renal replacement therapy could clear the middle and giant molecule toxins in the blood plasma of patients, it is theoretically treat refractory hypertension through reducing the toxin levels.OBJECTIVE: To observe the effect of continuous renal replacement therapy on maintenance hemodialysis patients with refractory hypertension.?METHODS: A total of 45 maintenance hemodialysis patients with refractory hypertension were randomly divided into two groups, hemodialysis group (n=22) and continuous blood purification group (n=23). Hemodialysis group underwent conventional hemodialysis treatment. Continuous blood purification group underwent conventional hemodialysis therapy, and treatment of continuous blood purification weekly.?RESULTS AND CONCLUSION: After 3 months of treatment, the renin activity, endothelin, angioten