透析液钠浓度与尿毒症患者血压和心脏功能的研究

目的：探讨透析液中钠浓度的不同对尿毒症患者的血压和心脏功能的不同影响。方法随机选取该院于2013年6月-2015年6月收治的108例合并高血压的尿毒症患者,根据随机数字表法分为观察组和对照组,观察组和对照组钠离子浓度分别为135 mol/L、143 mol/L其与成分相同,3次/周,4 h/次。两个月后,观察相关指标,研究钠离子浓度对患者血压及心脏功能的影响。结果透析后,观察组患者的血压[收缩压(169.5±11.6)mmHg；舒张压(92.7±6.1)mmHg]、体重(52.4±5.1)kg、LAD (41.3±2.8)mm、LVDd (42.6±4.1)mm、LVDs (33.8±2.5)mm较治疗前均显著降低,LVEF (55.2±4.8)%较治疗前显著增加。血红蛋白(85.4±10.3)g/L、血前白蛋白(37.9±6.2)g/L、BUN(25.4±4.2)mmol/L、SCr(823.3±82.6)umol/L、Kt/V(1.47±0.09)比较差异无统计学意义。对照组各项指标在治疗前后均差异无统计学意义。两组均有不良反应出现,其中低血压和透析失衡发生的频率差异无统计学意义,观察组低血压和透析失衡发生率分别为4.26%和4.36%,对照组分别为1.81%和3.51%。结论钠离子浓度直接影响尿毒症患者的血压和心脏功能,低钠更有利于降低血压和改善心脏功能,但加大了低血压和透析失衡的发生风险,因此应合理应用。

Relationship between Blood Pressure and Heart Function in Patients with Uremia and Dialysis Fluid Sodium Concentration

Objective To investigate the different effects of sodium concentration in dialysis solution on blood pressure and cardiac function in uremic patients. Methods The 108 cases of uremic patients with hypertension in our hospital in June 2013 to June 2015 admitted into observation group and control group, the observation group and the control group sodium ion concentrations were based on the random number table 135mol/L, 143mol/L with the same ingredients, 3 times/week, 4 h/times. Two months later, observe the relevant indicators to study the effects of sodium ion concentration on blood pressure and heart function. Results After dialysis, the blood pressure in the group of patients [systolic blood pressure (169.5 ± 11.6) mmHg;diastolic blood pressure (92.7 ± 6.1) mmHg], body weight (52.4 ± 5.1) kg, LAD (41.3 ± 2.8) mm, LVDd (42.6 ± 4.1) mm, LVDs (33.8 ± 2.5) mm compared with before treatment were significantly lower, (55.2 ± 4.8)% was significantly increased compared with before treatment LVEF. Hemoglobin (85.4 ± 10.3) g / L, prior to serum albumin (37.9 ± 6.2) g / L, BUN (25.4 ± 4.2) mmol / L, SCr (823.3 ± 82.6) umol / L, Kt / V (1.47 ± 0.09 ) ratio did not change significantly. The indicators in the control group before and after treatment were not significantly different. Adverse reactions in both groups, in which the frequency difference hypotension and dialysis disequilibrium occurred more significant observation group hypotension and dialysis disequilibrium rate of 4.26%and 4.36%, respectively, in the control group were 1.81%and 3.51%. Conclusion Sodium ion concentration has a direct impact on uremic patients blood pressure and cardiac function, low sodium in favor of reducing blood pressure and improve heart function, but increase the risk of hypotension and dialysis disequilibrium, there-fore should be rationally used.