强化降压对腹膜透析患者残余肾功能的影响被引量：1

Effect of intensive hypotension on residual renal function in peritoneal dialysis

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摘要目的观察强化降压治疗对腹膜透析患者残余肾功能的影响。方法选取规律腹膜透析患者68例,随机分为标准血压组(n=33)和严格血压组(n=35),标准血压组患者血压控制在130~140 mmHg/80~90 mmHg,严格血压组患者血压控制在120~130 mmHg/70~80 mmHg,随访12个月,观察两组残余肾功能的相关指标,分析两组血压水平与残余肾功能之间的相关性。结果随访期间,严格血压组发生心肌缺血梗死1例,标准血压组无心脑血管事件发生(P>0.05);两组患者在随访过程中残余肾功能均有下降,且在随访12个月时相关残余肾功能指标较入组时的变化有统计学意义(P<0.05)。随访6个月,严格血压组残肾每周KT/V较标准血压组更高(P<0.05);随访12个月,严格血压组每周KT/V、残肾GFR、尿量均高于标准血压组(P<0.05)。随访6个月,严格血压组残肾GFR较标准血压组下降率降低(P<0.05);随访12个月,严格血压组残肾每周KT/V、残肾GFR、尿量的下降率明显低于严格血压组(P<0.05)。随访12个月,两组患者的血压水平与残肾每周KT/V、残肾GFR、残肾每周CCr及尿量均成负相关(P<0.05);多元线性回归分析结果显示收缩压影响残肾GFR,舒张压影响残肾GFR和残肾每周KT/V(P<0.05)。结论将血压控制在120~130 mmHg/70~80 mmHg,能够延缓腹膜透析患者残余肾功能的丢失;强化降压治疗对腹透患者可能具有更好的残肾功能保护作用。 Objective To observe the effect of intensive hypotension on residual renal function in peritoneal dialysis patients.Methods A total of 68 patients were reviewed between January,in 2015 and December,in 2016 in The First Affiliated Hospital of Chengdu Medical College.There were 33 patients were randomly divided into standard blood pressure group(130~140 mmHg/80~90 mmHg),35 patients were randomly divided into strict blood pressure(120~130 mmHg/70~80 mmHg).During the follow-up period of 12 months,Data on all residual renal function were collected,and the correlation between blood pressure level and residual renal function was analyzed.Results During the follow-up period,1 case of myocardial ischemia infarction occurred in the strict blood pressure group,and no Cardiovascular and Cerebrovascular event occurred in the standard blood pressure group(P>0.05).Compared with the residual renal function of the entry group,the residual renal function decreased in both groups.At 12 months follow-up,the changes of the related residual renal function indexes were statistically significant.At 6 months follow-up,the residual renal kt/v in standard blood pressure group was lower than that in strict blood pressure(P<0.05).At 12 months follow-up,the residual renal KT/V,GFR and urine volume in the two groups were significantly lower than those in the standard blood pressure group(P<0.05).At 6 months follow-up,the decrease rate of GFR in strict blood pressure group was significantly lower than that in standard blood pressure group(P<0.05).At 12 months follow-up,the decrease rate of residual kidney KT/V,GFR and urine volume in standard blood pressure group was significantly higher than that in strict blood pressure group,the rate of residual renal function decreased more slowly,and there were statistical significantly differences.At 12 months follow-up,the level of blood pressure was negatively correlated with residual kidney KT/V,residual renal GFR,residual renal CCr and urine volume(P<0.05).Multiple linear regression analysis showed that systolic blood pressure affects residual renal GFR,and diastolic blood pressure affects residual renal GFR and residual kidney weekly KT/V(P<0.05).Conclusion Blood pressure was controlled at 120-130 mmHg/70-80 mmHg,the residual kidney function was reduced less.Intensive hypotension may have better protective effect on residual renal function in peritoneal dialysis patients.

作者高芳王少清马欣罗阳燕 Gao Fang;Wang Shaoqing;Ma Xing;Luo Yangyan(Department of Nephrology,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,Sichuan,China.)

机构地区成都医学院第一附属医院肾病科

出处《贵州医药》 CAS 2020年第4期525-528,F0003,共5页 Guizhou Medical Journal

基金 2014年度四川省医学会“施慧达”立项课题(编号:SHD14-11)。

关键词高血压强化降压腹膜透析残余肾功能 Blood pressure Hypertension Intensive hypotension Peritoneal dialysis Residual renal function

分类号 R544.1 [医药卫生—心血管疾病]

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参考文献2

1张锁建,章旭,曹娟,李海涛,蔡小琴,赵烨,徐煜.维持性腹膜透析患者尿素清除指数达标现状及影响因素分析[J].临床肾脏病杂志,2017,17(1):28-31. 被引量：8
2冯靖禧,程李涛,汪涛,陈伯钧.腹膜透析患者中预测残余肾功能下降的危险因素分析[J].中国血液净化,2008,7(8):410-413. 被引量：6

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