摘要
目的探讨腹膜透析高血压患者血压与容量超负荷和水盐的关系。方法随机选择我院门诊连续3个月随诊的165例腹膜透析患者,分为血压持续升高组(PH,33),血压波动组(IH,58),血压正常组(PN,74),而IH组义分为血压正常(IH—N)和血压升高两组(IH-H)。用生物阻抗分析仪评估患者的容量指标。结果3组在年龄、性别、透析时间的构成比上均无显著性差异。PH组的体重比IH组和PN组高(P<0.05)。生物阻抗分析显示,PH组和IH-H组的细胞外液(ECW)、总体液量(TBW),高于IH-N组和PN组(P<0.01)。总液体清除量在PH组和IH—H组均高于IH-N和PN组(P<0.05)。与PH组和IH—H比较,总钠清除量和血钠浓度在IH—N和PN组均低(P< 0.05)。3组的总尿素清除指数Kt/V均无显著性差异。结论腹膜透析患者发生高血压时伴明显容量超负荷,而且在容量超负荷时钠和液体的清除均明显增高,提示饮食中水盐的摄入增加是患者出现容量超负荷的主要原因。
Objective To investigate the role of salt and fluid intake in the development of hypertension in CAPD patients. Methods Based on the blood pressure in three consecutive months, 165 stable CAPD patients were divided into three groups: persistent hypertensive (PH) (n=33), intercurrent hypertensive (IH) (n=58) and persistent normotensive (PN) (n=74). The IH group was further divided into two phases: normotensive (IH-N) and hypertensive phase(IH-H). Fluid status was evaluated by bioimpedance analysis(BIA). Results There were no differences in age, gender, and duration of dialysis among the three groups. The weight in PH and IH-H groups were higher than that in PN and IH-N groups (P<0.05). Extracellular water (ECW) and total body water (TBW) in PH and IH-H groups was higher than those in PN group(P < 0.01). Moreover, the ECW and TBW in IH-H group were also higher than those in IN-N group[(16.61 ±3.54) L versus (15.36±3.30) L for ECW, P< 0.05 and (31.79±6.67) L versus (30.25±6.62) L, P< 0.01]. The total fluid removal (TFR) in PH and IH-H groups was higher than that in PN group [ (1346.82±431.27) ml/d,( 1311.55±518.14) ml/d and (1139.28±412.65) ml/d, respectively ,P < 0.05 ]. Compared with PH and IH-H groups, the total sodium removal (TSR) and serum sodium concentration in IH-N and PN groups were also lower (all P < 0.05). Conclusions Fluid overload is the key factor for the development of hypertension in CAPD patients. Hypertensive patients have higher fluid and sodium removal than normotensive patients, suggesting excess fluid and sodium intake is the major reason for the development of fluid overload and hypertension in these patients.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2005年第6期367-369,共3页
Chinese Journal of Nephrology
基金
中华人民共和国教育部长江学者奖励计划(985工程)基金(36-1)
