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目的:探讨树脂灌血液灌流对血液透析顽固性高血压患者血压及肾素-血管紧张素-醛固酮系统的影响。方法:选择我院82例,均分为Ⅰ组和Ⅱ组各41例,Ⅰ组患者采用金宝8LR聚酰胺膜透析器进行常规透析,Ⅱ组患者在常规透析的基础上串联树脂血液灌流,检测两组患者治疗前和治疗后3个月血清肌酐、尿素氮变化情况,和患者体内肾素活性、血管紧张素Ⅱ和醛固酮变化情况,并对血压变化值进行比较。结果:两组患者治疗后3个月血肌酐、血尿素氮均明显较治疗前降低,Ⅰ组患者治疗后3个月收缩压和舒张压较治疗前均无明显变化,Ⅱ组治疗后3个月收缩压和舒张压均较治疗前明显降低,Ⅰ组治疗后3个月肾素、血管紧张素Ⅱ和醛固酮较治疗前无明显差异,Ⅱ组治疗后3个月肾素、血管紧张素Ⅱ和醛固酮较治疗前均明显降低。结论:血液透析联合树脂吸附灌在保证有效清除患者体内代谢物质的同时,能较好的控制患者血压。
Objective: To investigate the effect of resin perfusion on blood pressure and renin-angiotensin-aldosterone system in hemodialysis patients with refractory hypertension. Methods: Eighty-two patients in our hospital were divided into group Ⅰ and group Ⅱ, 41 cases in each group. Patients in group Ⅰ were treated with Campbell 8LR polyamide membrane dialyzer for routine dialysis. In group Ⅱ, hemodialysis was performed on the basis of conventional dialysis. The changes of serum creatinine and urea nitrogen and the renin activity, the changes of angiotensin Ⅱ and aldosterone in two groups before treatment and 3 months after treatment were compared, and the changes of blood pressure were compared. Results: Serum creatinine and blood urea nitrogen were significantly decreased in both groups at 3 months after treatment, and systolic and diastolic blood pressure did not change significantly at 3 months after treatment in group Ⅰ compared with those before treatment. In group Ⅱ, 3 Month systolic blood pressure and diastolic blood pressure were significantly lower than before treatment, Ⅰ group 3 months after treatment, renin, angiotensin Ⅱ and aldosterone no significant difference compared with before treatment, three months after treatment in group Ⅱ renin, angiotensin Ⅱ And aldosterone than before treatment were significantly lower. Conclusion: Hemodialysis combined with resin sorption irrigation can effectively control the blood pressure of patients while ensuring the effective removal of metabolites in patients.