血液透析联合血液灌流对血液透析患者难治性高血压的影响

目的探讨血液透析联合血液灌流对尿毒症难治性高血压患者的疗效和可行性。方法将26例维持性血液透析患者随机分为两组：血液灌流串联血液透析（HD4-HP）组13例，每例患者在2周5次常规血液透析的同时，每周1次HD＋HP治疗；常规血液透析（HD）组13例，每周3次HD治疗。观察两组治疗前及治疗后血压、肾素（PRA）、血管紧张素Ⅱ（ATⅡ）、同型半胱氨酸（Hcy）的变化。结果HD4-HP组治疗后血压明显下降，治疗前后比较差异有统计学意义（P〈0．01）；HD＋HP组治疗前后比较，PRA、ATⅡ、Hcy明显下降，差异有统计学意义（P〈0．05）；HD组治疗前后PRA、ATⅡ、Hcy无明显变化（P〉0．05）。治疗后HD＋HP组PRA、ATⅡ、Hcy较HD组明显下降，差异有统计学意义（P〈0．05）。结论血液灌流串联血液透析对尿毒症难治性高血压患者有明显的治疗效果。

Effect of hemodialysis combined with hemoperfusion on hemodialysis patients with refractory hypertension

Objective To investigate the effect and feasibility of hemodialysis （HD） combined with hemoperfusion （HP） on uremic patients with refractory hypertension. Methods Twenty-six patients underwent maintenance hemodialysis were randomly divided into two groups ： Thirteen patients in HD ＋ HP group were given conventional hemodialysis, 5 times every 2 weeks, at the same time, HD ＋ HP treatment once a week ; Thirteen patients in conventional HD group were given HD treatment, 3 times per a week. The changes of the blood pressure, PRA, AT ]] and Hcy before and after treatment were observed. Results After treat- ment, the blood pressure significantly decreased in HD ＋ HP group, and there was significant difference before and after treat- ment （P 〈0. 01 ） ; The levels of PRA, ATII and Hcy significantly decreased in HD ＋ HP group, the differences were significant （P 〈 0.05 ） ; But the levels of PRA, AT II and Hcy had no significant difference before and after treatment in HD group （ P 〉 0. 05）. Compared with HD group, the levels of PRA, AT II and Hcy significantly decreased after treatment, there were significant differences （P 〈 0. 05）. Conclusion Hemoperfusion combined with hemodialysis has obvious therapeutic effect on uremic patients with refractory hypertension.