维持性血液透析患者透析充分性和营养状况与血压及心血管症状的临床研究

目的观察维持性血液透析(MHD)患者透析充分性和营养状况与血压及心血管症状的关系。方法 120例MHD患者连续测量6次透析前后的血压,并计算平均动脉压。同时,透析前后抽血测定生化值、甲状旁腺激素(PTH)、血红蛋白(Hb)、血细胞比容(Hct)等;拍摄X线胸片测心胸比例,计算尿素清除指数(KT/V)、尿素氮清除率(URR)、时间平均尿素浓度(TACurea),调查和记录MHD患者心血管症状发生情况。结果 KT/V与Hb、血清白蛋白、PTH及Hct有相关性(P<0.05);透析充分组和透析不充分组透析后血压比较差异有统计学意义(P<0.05);营养状况良好组与营养状况不良组透析前血压比较差异有统计学意义(P<0.05);透析充分组和营养状况良好组心血管症状发生率较透析不充分组和营养状况不良组明显减少。结论充分透析和良好的营养状况可使MHD患者的血压得到良好控制,减少心血管症状的发生。

A Clinical Study on Dialysis Adequacy and Nutritional Status Compared with Blood Pressure and Cardiovascular Symptoms of Maintenance Hemodialysis Patients

Objective To observe the relationship of dialysis adequacy and nutritional status with blood pressure and cardiovascular symptoms of the maintenance hemodialysis(MHD)patients.Methods The blood pressure of 120 MHD patients before and after hemodialysis were measured 6 times including systolic,diastolic,and to the mean arterial blood pressure was calculated.And before and after the hemodialysis,blood biochemical values,PTH,Hb,and Hct were tested.The chest X-ray was taken for measuring cardiothoracic ratio,calculation of the values of KT/V,URR,TACurea,to investigate and record the cardiovascular symptoms of the MHD patients.Results KT/V and Hb,Alb,PTH and Hct were correlated(P<0.05).The difference of blood pressure between the two groups of adequate dialysis and inadequate dialysis after hemodialysis was statistically significant(P<0.05);and the two groups of nutritional group and malnutritional group before hemodialysis was statistically significant(P<0.05).The incidence of cardiovascular symptoms of adequate dialysis group and nutrition group compared with inadequate dialysis group and malnutrition group was significantly reduced.Conclusion Sufficient dialysis and better nutritional status can make the MHD patients blood pressure well controlled and reduce the incidence of cardiovascular symptoms.