老年血液透析患者干体质量下降与顽固性高血压关系研究.pdfVIP

424 2011 525 5 Journal of Chinese Practical Diagnosis and Therapy * 张 冬, 孙雪峰, 朱晗玉, 陈香美 ( , 100853) [] :探讨老年维持性血液透析患者干体质量变化与 固性高血压的关系:行维持性血液透析老年 患者12 例,透析前坐位血压均 140/90 mm Hg, 至少服用3 种降压药根据患者血压变化逐渐降低干体质量, 直至透 析前坐位血压 140/90 mm Hg,服用 1种降压药或患者1 周内连续2 次透析过程中出现低血压或肌肉抽搐患者均行 常规血液检查透析充分性评估X 线胸片心脏超声及下腔静脉超声检查,并每3 个月复查上述检查项目: 12 例 患者中10 例血压达到目标值, 2例因在透析中反复出现肌肉抽搐症状而停止降低干体质量10 例患者中位干体质量下 降1. 1( 0.3~ 1.5) kg; 研究结束时干体质量收缩压平均动脉压下腔静脉直径及心胸比均较研究开始时下降( P 005) ;血压达到目标值时间为14~ 44(28.33 8.78) 周: 降低透析患者干体质量可改善患者高血压水平, 干体质 量过高增加1 kg 即可导致老年患者 固性高血压的发生 [] 维持性血液透析;干体质量; 高血压 :R459.5 :A : 2011 Relationship between dry weight reduction and resistant hypertension in the el derly mai ntenance hemodialysi s pati ents ZHA G Dong, SU Xuefeng, ZHU Hanyu, CHE Xiangmei Department of ephrology, General Hospital of PLA, Kidney Center and Key Laboratory of PLA, Beijing 100853, China [ Abstract] Objective To investigate the relationship between the change of dry weight and refractory hypertension in the elderly maintenance hemodialysis patients. Methods Twelve elderly patients with refractory hypertension who had undergone hemodialysis for more than one year were recruited and studied. T he sitting blood pressure before hemodialysis was higher than 140/ 90 mm Hg and at least 3 kinds of depressors were admitted. T he dry weight decreased by degrees with the level of blood pressure until the sitting blood pressure was lower than 140/ 90 mm Hg, and one kind of depressors was admitted, or hypotension or spasticity of muscle happened twice during hemodialysis in a week. T he hemoglobin, albumin, triacylglycerol and cholesterol levels were determined. The hemodialysis adequacy was evaluated. All of