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目的:观察血液灌流联合血液透析对肾功能衰竭难治性高血压的影响,以期为临床制定合适透析方案提供依据。方法:将行3次/周规律透析伴难治性高血压的肾功能衰竭患者70例随机分为2组,在常规口服降压药物及标准血液透析基础上,A组(36例)行血液灌流1次/个月,B组(34例)血液灌流3次/周,5次后改为1次/个月,疗程3个月,比较治疗前、后2组患者平均动脉压、血清甲状旁腺素和血管紧张素-Ⅱ水平变化,并观察患者治疗后反应。结果:2组治疗前、后各参数变化差异均有统计学意义(P<0.05),与A组比较,B组治疗后各参数变化更明显(P<0.01)。治疗后2组患者精神、食欲等均较治疗前改善,A组16例瘙痒者9例症状缓解,B组15例瘙痒者3个月后症状均消失。结论:血液灌流联合血液透析可有效控制尿毒症患者顽固性高血压症状,疗效与治疗频度有关。
Objective: To observe the effect of hemoperfusion combined with hemodialysis on refractory hypertension with renal failure, in order to provide a basis for clinical development of a suitable dialysis program. Methods: Seventy patients with renal failure who underwent regular dialysis 3 times / week and refractory hypertension were randomly divided into 2 groups. On the basis of routine oral antihypertensive drugs and standard hemodialysis, group A (36 cases) The rats in group B (34 cases) were perfused three times a week for 3 times a week for 5 times and then treated for 3 months. The mean arterial pressure, serum thyroid Parathyroid hormone and angiotensin-Ⅱ levels, and observe the patient response after treatment. Results: Before and after treatment, there were significant differences in parameters between the two groups (P <0.05). Compared with group A, the parameters of group B changed more obviously (P <0.01). After treatment, the mental and appetite of patients in two groups improved compared with those before treatment, and the symptoms of 9 patients with pruritus in group A were relieved. The symptoms of 15 patients with pruritus in group B disappeared after 3 months. Conclusion: Hemoperfusion combined with hemodialysis can effectively control the symptoms of refractory hypertension in uremic patients. The curative effect is related to the frequency of treatment.