可变钠透析对血压的作用与可能机制

目的：探讨可变钠碳酸氢盐透析与标准钠碳酸氢盐透析比较,其对血液透析的作用与可能机制。方法：采用随机交叉对照研究,观察31例慢性功能衰竭的血液透析病人,采用标准钠透析（SSD）和可变钠透析（VSD）后血清钠,血清钠活性的变化以及单次透析前后和3个月血压的改变,并比较并发症的发生情况。结果：采用SSD3个月后透前血压有显著升高,原血压正常尤为明显,而VSD血压无显著变化。单次透析时,SSD使血清钠活性升高,在VSD时则无显著影响。血清钠均无显著性变化。主要并发症无显著差异,结论：VSD比SSD更有利于防治透析病人高血压的发生,特别是对原血压正常者,其原因可能与体液分布和交换钠的不同变化有关。

Influence of vaiable-sodium dialysis on blood pressure and probably mechanism

Objective To investigate the changes in blood pressure during the process of variable-sodium dialysis (VSD) and standard-sodium dialysis(SSD).Methods It was a random crossover study with controlled assignment order.Thirty-one chronic hemodialysis patients were selected to receive SSD and VSD respectively,and the change in serum sodium activity was observed.The change in blood pressure and complications were also recorded during the single dialysis session as well as during each three months trial.Results After three months trial,blood pressure was significantly elevated in patients who receive SSD,especially in those was nonhypertensive.Whereas,blood pressure wasn't elevated in those who received VSD for three months.Serum sodium activity was gradually elevated during single SSD sessions and there was no change during single VSD sessions.Conclusions VSD can reduce the incidence of hypertension due to dialysis.One of causes was that VSD can change serum sodium activity in chronic dialysis patients.