含糖透析液对糖尿病肾病血液透析患者血压及心率变异性影响.doc

含糖透析液对糖尿病肾病血液透析患者血压及心率变异性影响[摘要] 目的 研究含糖透析液对糖尿病肾病(DN)患者血液透析(HD)中血压和心率变异性(HRV)的影响。方法 选取92例接受HD治疗的DN患者，按透析液是否含糖分为：研究组(含糖透析液) 45例与对照组(不含糖透析液) 47例。比较两组间在透析前、中、后收缩压(SP)、舒张压(DP)、平均血压(MBP)及血糖(GLU)水平的差异。HRV时域指标(低频谱、高频谱)与频域指标(SDNN、PNN50)的差异。结果 与对照组相比，研究组透析前SP、DP、MBP及GLU无统计学意义（P＞0.05），但透析中、后SP、DP、MBP及GLU较高（P＜0.01）；研究组高频谱与PNN50无统计学意义（P＞0.05），而低频谱与SDNN降低（P＜0.01）。结论 含糖透析液对DN患者HD中血压和HRV影响小，不过度激活交感神经。 [关键词] 含糖透析液；糖尿病肾病；血液透析；心率变异性 [中图分类号]R587.2[文献标识码] B [文章编号] 1673-9701（2011） 25-31-03 The Influence of Blood Pressure and Heart Rate Variability in Diabetic Nephropathy Patients Received with Glucose Containing Dialysate REN Ying1 HU Zuoxiang2SHAN Wei1SHAN Caidi1 1.Department of Renal Medicine, Shaoxing Hospital, China Medical University, Shaoxing 312030，China; 2. Department of Renal Medicine, People’s Hospital of Shaoxing , Shaoxing 312000, China [Abstract] Objective To investigate the influence of glucose containing dialysate(GD) on incidences of blood pressure(BP)and heart rate variability（HRV）in diabetic nephropathy patients（DN）. Methods A total of 92 hemodialysis patients with DN were divided into two groups, research group received with GD, 45 cases, and control group received with non-GD 47 casesaccording to dialysis fluid content. The systolic pressure（SP）, diastolic pressure（DP）, mean blood pressure(MBP) and blood glucose（GLU）at pre-, mid-, pos-themodialysis session were compared between two groups. And HRV time-domain indexs（low frequency, high frequency）and frequency-domain indexs（SDNN、PNN50）were also compared in both groups. Results Compared to control group, the SP, DP, MBP and GLU at prehemodialysis session in research group were no difference （P＞0.05）, and the above indexes at mid- and post-hemodialysis session in research group were lower（P＜0.01）. The high frequency and PNN50 were no difference in both groups（P＞0.05）, and the low frequency and SDNN in research group were lower than those in control group（P＜0.01）. Conclusion The influence of GD on incide