摘要
目的评价在维持性血液透析患者中应用含糖透析液和无糖透析液对心率变异性(heart rate variability,HRV)、血压和血糖的影响。方法纳入10名稳定的非糖尿病的慢性血液透析患者。每个患者进行2次无糖透析液透析,2次含糖透析液透析,每次透析4h,形成无糖透析液组和含糖透析液组,每次透析过程中均对患者进行HRV连续监测,在透析0、1、2、3、4h进行血压、血糖的监测。观察含糖透析液对HRV指标和血压、血糖的影响。统计方法采用重复测量的方差分析。结果无糖透析液组和含糖透析液组透析时的心率和血压的基线值可比。在透析过程中,无糖透析液组的收缩压较含糖透析液组时明显升高,第4h的平均收缩压差别有统计学意义(F=1718.10,P<0.05)。无糖透析液组发生3人次低血糖,含糖透析液组没有出现低血糖。无糖透析液组标准化低频功率较含糖透析液组显著升高(t=4.31,P<0.05),而标准化高频功率较含糖透析液组显著降低(t=-3.71,P<0.05)。无糖透析液组低频功率/高频功率(LF/HF)较含糖透析液组偏高,但差异无统计学意义(t=0.66,P>0.05)。结论透析过程中使用无糖透析液可能引起交感神经的过度激活,继而引起高血压。血液透析患者使用含糖透析液可能有益。
Objective Heart rate variability （HRV） is related to autonomic nervous system disturbance.The aim of current study was to evaluate whether dialysates with glucose （DG） and dialysate without glucose （DNG） affect HRV,blood pressure and blood glucose during hemodialysis （HD） sessions.Methods Ten stable nondiabetic chronic HD patients were enrolled in this study.Each patient underwent 4 HD sessions,of which twice used DG and twice used DNG.Patients were dialyzed for 4 hours per session.During every dialysis session,heart rate was recorded continuously;blood pressure and blood glucose were measured at 0,1st,2nd,3rd and 4th hour in the session.The influence of DG on HRV index,blood pressure and blood glucose was studied.Analysis of variance for repeated measurements was used for statistical analysis.Results Baseline heart rate and blood pressure were comparable when patients used either DNG or DG.During HD sessions,systolic arterial pressure was significantly higher when patients used DNG than they used DG （F=1718.10,P 0.05）.The occurrence of hypoglycemia was less when patients used DG.In patients using DNG,normalized low-frequency was significantly higher while normalized highfrequency was lower,compared with those when using DG （P 0.05,t =-3.71）.The low-frequency/high-frequency ratio was higher in patients when using DNG than when using DG,but without statistically significance （t=0.66,P 0.05）.Conclusion Hemodialysis using DNG may cause hyperactivity of sympathetic nerve system and hence hypertension during HD session.HD patients may benefit from glucose containing dialysate.
出处
《中国血液净化》
2010年第3期138-142,共5页
Chinese Journal of Blood Purification
关键词
含糖透析液
血液透析
心率变异性
低血糖
Dialysate with glucose
Hemodialysis
Heart rate variability
Hypoglycemia
