透析中高血压的发病机制及干预措施.pdfVIP

竖照痘皇适垣竖整蕉盘壶星垫鲞筮!翅垫!!生!!旦 ·565· ·an液净化· 透析中高血压的发病机制及干预措施 任红旗1综述何慈江2审校 摘要透析中高血压发病率为5％～15％，与透析患者预后密切相关。透析中高血压发病机制、治疗策略目 前尚不明确，可能的发病机制包括细胞外液容量负荷、心输血量增加、电解质紊乱(尤其是钠离子)、肾素．血管紧张 素系统激活、交感神经系统过度活跃及内皮细胞功能不全等。主要治疗方案包括控制容量、减少钠的摄入、降低交 感神经系统活性及减少内皮素的水平等。 关键词透析中高血压发病机制治疗进展 of inthe andinterventionmeasures Pathogenesishypertensionhemodialysis PEN a和昭 Hong—qi，HE 97 1Departmentofnephropathy，XuzhouHosptial，Xuzhou，221000。China 2Division School ofNephrology，DepartmentofMedicine，Mount＆船iofMedicine，NewYork，USA ABSTRACT increaseinblood or after Intradialytichypertension．defined船all pressureduringimmediately thatresultsin been to the hemodialysis postdialysishypertension，haslong recognizedcomplicatehemedialysisprocedure， oftenis ofthis estimatedtobe yet is 5％～15％in largelyignored．Theprevalencedialyticcomplication hemodialysis itseemstobeassociatedwithadverseoutcomes．The mechanismsthat beinvolvedinthe patients，and might pathogenesis of include extracellularvolume cardiac in levels intradialytichypertension overload，increased output，changeselectrolyte ofthe ofthe nervous (particularlysodium)，activationrenin-angiotensin-aldosterone