含糖透析液对维持性血液透析患者血糖、血压及代谢的影响

目的 探讨含糖透析液对维持性血液透析(maintenance hemodialysis,MHD)患者血糖、血压及代谢的影响.方法 选择西安交通大学医学院第一附属医院血液净化科MHD患者50例,采用数字表法随机分为无糖透析液组、含糖透析液组,血液透析(hemodialysis,HD)时分别使用无糖透析液和葡萄糖浓度为5.5 mmol/L的含糖透析液,持续观察3个月,并检测患者每次透析开始、透析2h、透析结束时血糖和血压,及观察期前后的血清白蛋白、糖化血红蛋白、血脂等指标.结果 无糖透析液组低血糖和低血压的发生率均高于含糖透析液组(P＜0.05),两组患者透析各时间点血糖水平差异无统计学意义(P＞0.05).两组患者在观察期前与观察期结束后血清白蛋白水平、糖化血红蛋白、血脂等差异无统计学意义(P＞0.05).结论 维持性血液透析患者应用葡萄糖浓度为5.5 mmol/L的含糖透析液能降低透析过程中低血糖和低血压的发生率,且不影响血清白蛋白、糖化血红蛋白、血脂等指标,具有安全性、可靠性.

Effects of dialysate with glucose on serum glucose,blood pressure and metabolism in maintenance hemodialysis patients

Objective To investigate the influence of glucose containing dialysate on serum glucose,blood pressure and metabolism in maintenance hemodialysis patients.Methods Fifty chronic renal failure patients were selected from our dialysis unit.We divided the patients into glucose-free dialysate group and glucose-containing dialysate group.When hemodialysis,they respectively used a dialysate with a glucose-free dialysate and a glucose concentration of 5.5 mmol/L of glucose-containing dialysate.We measured the levels of serum glucose and blood pressure at three time points (predialysis and 2 h and 4 h after the initiation of dialysis),and metabolic indicators before and after the observation period.The observation time is 3 months.Results The incidence rate of hypoglycemia and hypotention when using glucose-containing dialysate was significantly lower than no glucose-containing dialysate (P ＜ 0.05).The level of serum albumin and lipoprotein and glycosylated hemoglobin showed no significantly difference before and after the observation for both groups (P ＞ 0.05).Conclusions Glucose containing dialysate can decrease the morbidity of hypoglycemia and hypotention during HD for MHD patients.It is safe and reliable for MHD patients and the associated biochemical indicators seem not to be influenced.