低温透析避免低血压发生的机制

目的 探讨低温透析纠正低血压的疗效和机制。方法 选取我院长期规律透析患者中容易发生低血压或者血压偏低者16例，分别采用常温透析（37℃）和低温透析（35．5℃）交叉透析，各4次。自身前后对照，每次透析观察血压、心率、相对血容量（RBV）以及体温的变化，并且在透析末平卧采静脉血检查血管紧张素Ⅱ、肾上腺素和皮质醇的变化。结果 与常温透析比较，低血压发生率低（低温组22．3％，常温组为34．2％），低血压出现的时间晚（常温组3．954-0．44h，低温组4．43±0．56h，P=0．037），血压、心率高，相对血容量低（低温组为0．73±0．11，常温组为0．82±0．09，P=0．022），透析后血管紧张素Ⅱ、肾上腺素和皮质醇升高（P〈0．05）。结论 低温透析能够降低透析相关性低血压的发生机率。通过诱发机体应激反应，使血管紧张素、皮质醇和肾上腺素释放增加，来达到纠正低血压发生。

Initial Study on Low Temperature Dialysis in Treating Hypotension

Object To study the mechanism of low temperature dialysis in treating hypotension. Method 16 long-term dialysis patients who are hypotensive or prone to hypotension were chosen to undertake 4 periods of corss dialysis with a common temperature （3712） and low temperature （35.5℃）. The change of blood pressure, heart rate, RBV and bldy temperature during each dialysis were observed. The blood angiotonin, adnephrin and cortisol concentration were detected at the end of each dialysis. Atuo-control method was used to analyze the data. Result Compared with the common temperature group, the blood pressure and heart rate are high in the low tem- perature dialysis group, and the incidence rate of hypotension is lower; the occurrence time of hypotension is later; and the concentration of angiotonin, adnephrin and cortisol is higher. Conclusion Low temperature dialysis can cut down the probability of hypotension. Low temperature dialysis retrieves hypotension through inducing body emergency reaction.