透析患者顽固性高血压治疗策略分析.docVIP

透析患者顽固性高血压治疗策略分析 　　[摘要] 目的 探讨透析患者顽固性高血压的治疗方法和效果。方法 方便选取该院2015年3月―2017年3月收治的MHD顽固性高血压患者76例，随机分为2组各38例，观察组给予苯磺酸左旋氨氯地平片联合缬沙坦治疗，对照组给予硝苯地平缓释片联合缬沙坦治疗，比较疗效与治疗前后血压情况。结果 观察组总有效率为92.1%，明显优于对照组76.3%（P0.05）；治疗后观察组收缩压（147.8±7.2）mmHg、舒张压（80.8±5.9）mmHg下降幅度明显优于对照组收缩压（161.2±6.5）mmHg、舒张压（100.5±6.1）mmHg（P0.05）。 结论 苯磺酸左旋氨氯地平联合缬沙坦，对MHD患者顽固性高血压有显著的降压和保护肾功能效果，能有效改善患者生活状态。 　　[关键词] 血液透析；顽固性高血压；策略 　　[中图分类号] R692 [文献标识码] A [文章编号] 1674-0742（2018）01（b）-0108-03 　　[Abstract] Objective To study the treatment method and effect of dialysis patients with resistant hypertension. Methods 76 cases of patients with resistant hypertension admitted and treated in our hospital from March 2015 to March 2017 were commodiously selected and randomly divided into two groups with 38 cases in each， the observation group were treated with levamlodipine besylate tablets and valsartan， while the control group were treated with extended release nifedipine tablets and valsartan， and the curative effect and blood pressure before and after treatment were compared. Results The total effective rate in the observation group was obviously better than that in the control group， （92.1% vs 76.3%）（P0.05）， after treatment， the systolic pressure and diastolic pressure decrease degrees in the observation group were obviously better than those in the control group， [（147.8±7.2）， （80.8±5.9）mmHg vs （161.2±6.5）， （100.5±6.1）mmHg]（P0.05）. Conclusion The levamlodipine besylate tablets and valsartan has an obvious depressurization and renal function protective effect in MHD patients with resistant hypertension， which can effectively improve the living state of patients. 　　[Key words] Dialysis； Resistant hypertension； Strategy 　　近年?恚?慢性肾脏病已成为危害全世界人民健康的公敌之一。据国际肾脏病协会统计[1]，慢性肾功能衰竭（CRF）在自然人群中的年发病率为98/100万～198/100万。在我国因各种继发性因素引起肾功能衰竭发生率逐年递增。血液透析是治疗CRF的主要方法，但长期的透析治疗可使原有肾脏功能逐渐退化直至消失，引发各种严重的并发症。顽固性高血压是血液透析中常见的并发症之一，尤其在维持性血液透析（MHD）患者中，发生率高达80%～90%[2]，大大提高了发生心力衰竭的风险，也是引起透析患者死亡的主要原因。因此，改善MHD患者的血压状态，对延长患者生存率、提高生命质量至关重要。该研究通过对该科2015年3月―2017年3月收治的