摘要
目的:比较腹膜透析(CAPD)和血液透析(IHD)对尿毒症患者顽固性高血压的影响及对其肾素活性、内皮素、血管紧张素Ⅱ清除率的影响。方法:符合入选标准的50例尿毒症并顽固性高血压的患者随机分为CAPD组和IHD组,记录患者治疗前后肌酐(Cr),尿素氮(BUN)、血红蛋白(Hb)、血球压积(Hct)、肾素活性(RA)、内皮素(ET)、血管紧张素Ⅱ(AngⅡ)和24 h动态血压的变化,比较两组治疗后的RA、ET、AngⅡ和24 h动态血压。结果:①治疗6个月后两组肌酐,尿素氮,血红蛋白,血球压积均有明显改善(P<0.05),但组间比较无显著性差异(P>0.05)。②治疗6个月后CAPD组24 h平均血压、RA、ET、AngⅡ均有明显改善(P<0.05),而IHD组无明显改变(P>0.05);组间比较有显著性差异(P<0.05)。结论:①腹膜透析和血液透析两种透析方式均可以很好的清除尿毒症小分子毒素,改善尿毒症贫血状态和毒素水平。②腹膜透析比血液透析更有利于清除肾素、内皮素、血管紧张素Ⅱ,从而能更好地控制尿毒症顽固性高血压。
Objective：To compare the effects of intermittent hemodialysis（IHD） and continuous ambulatory peritoneal dialysis（CAPD） on blood pressure and on the serum level of angiotensinⅡ（AngⅡ）,endotheline（ET） and rennin activity（RA） in uremic patients with refractory hypertension.Methods： Fifty uremic patients with refractory hypertension were randomly divided into CAPD group or IHD group.The age,blood pressure,Hb,Hct,AngⅡ,ET,BUN,Cr and RA were measured before and after treatment.The levels of RA,ET,AngⅡ and 24 h BP were compared between two groups.Results：①After 6 month treatment,The levels of BUN and Cr,Hb and Hct were obviously changed in both groups（P〈0.05）,and no difference was shown about these parameters between two groups.②After 6 month treatment,the levels of 24 h BP,RA,ET AngⅡ were significantly lower in CAPD group（P〈0.05）,but no significant change was seen in IHD group（P〉0.05）;and significant change was shown about these parameters between two groups（P〈0.05）.Conclusion：①Both CAPD and IHD could clear Low-Molecular-Weight Inuremic patients and improve their anemia condition.②CAPD induces more effective clearance of serum AngⅡ,ET,and RA,which may be the reason for the more effective control of hypertension.
出处
《实用临床医学（江西）》
CAS
2007年第7期18-20,30,共4页
Practical Clinical Medicine
