血液透析患者超滤量与血压节律和心功能的关系

目的 探讨血液透析患者超滤与血压昼夜节律及心脏结构和功能的关系.方法 维持性血液透析患者42例,对患者加强透析超滤4周,分别检测超滤前后血肌酐、尿素氮、钾、钠及动态血压和心脏彩超.结果 根据24 h动态血压监测发现血液透析患者非杓型血压比例明显升高;超滤前后血压节律和心脏结构有显著性改变(P<0.05),平均每次超滤量与血压和心脏结构变化具有相关性(P<0.05).结论 血液透析患者的夜间高血压与高血容量有关,通过加强超滤可有效控制夜间高血压并改善心功能.

The relationship of ultrafiltration with diurnal rhythm of blood pressure and cardiac function in hemodialyzed patients

Objective To investigate the relationship among ultrafiltration (UF), diurnal rhythm of blood pressure (BP) and cardiac structure and function in hemodialyzed(HD) patients. Method 42 hemodialyzed patients were studied. Intensified UF during routine HD were given to them for 4 weeks. Before and after 4 weeks, everyone received 24 hours ambulatory blood pressure monitoring and cardiac doppler and recorded diameter of left atrium (LAD) ,left ventricle (LVEDD), thickness of posterior wall of left ventricle during end stage of diastolic period (LVPWT) ,thickness of interventricular septum(IVST) ,ejection fraction (EF). Result In hemodialyzed patients, non-dipper hypertension was much more than dippers (P < 0.05). There was significant difference between nocturnal BP and cardiac structure before and after 4 weeks of hemodialysis ( P < 0.05 ). Conclusion Nocturnal hyperten- sion of hemodialyzed patients is related to hypervolemia. Intensive ultrafihration can improve nocturnal hypertension and eardiac function.