血清钠活性改变在可变钠与标准钠透析中的意义

目的：探讨可变钠碳酸氢盐与标准钠碳酸氢盐透析时血清钠活性的变化以及对血压的影响。方法：采用随机交叉对照研究，观察31例慢性肾衰的血透病人分别采用可变钠透析（VSD）和标准钠透析（SSD）血清钠活性的变化以及单次透析前后和3个月后血压的改变。结果：单次透析过程中SSD使血清钠活性逐渐升高，VSD则无显著影响。透析2个月后SSD使血压显著升高，原血压正常者尤为明显；而VSD则不升高血压，并且可使收缩压下降。结论：VSD能减少透析性高血压的发生。其原因之一可能与改变了血清钠活性有关。

Change of Serum Sodium Activity in Variable -sodium Dialysis and Standard-sodium Dialysis

Objective:To investigate the change of serum sodium activity and blood pressure during variable-sodium dialysis (VSD) and standard-sodium dialysis (SSD).Methods:It was a random crossover study with controlled assignment order.Twenty-one chronic dialysis patients were selected to receive VSD and SSD respectively,and the change of serum sodium activity was observed.The changes of blood pressure was also recorded during the single dialysis session as well as during each three months trial.Results:Serum sodium activity was gradually elevated during single SSD sessions while it was not during single VSD sessions.After three months trial,blood pressure was significantly elevated in patients who received SSD,especially those nonhypertension.Instead of elevated blood pressure,systolic pressure was decreased in those recieved VSD of three months.Conclusions:VSD could reduce the incidence of hypertension due to dialysis.One of reasons may be that VSD could change serum sodium activity in chronic dialysis patients.