中国血液净化

›› 2011, Vol. 10 ›› Issue (02): 80-82.doi: 10.3969/j.issn.1671-4091.2011..00

• 临床研究 • 上一篇    下一篇

超滤速度对终末期糖尿病肾病患者发生透析中低血压的影响

李锐钊 梁馨苓 陈源汉 刘双信 夏运风 李志莲 李 卓 史 伟   

  1. 广东省人民医院 广东省医学科学院肾内科血液净化中心
  • 收稿日期:2010-09-25 修回日期:1900-01-01 出版日期:2011-02-12 发布日期:2011-02-12
  • 通讯作者: 史伟

The effect of ultrafiltration rate on the intradialytic hypotension in patients with end stage diabetic nephropathy

LI Rui-zhao, LIANG Xin-ling, CHEN Yuan-han, LIU Shuang-xin, XIA Yun-feng, LI Zhi-lian, LI Zhuo, SHI Wei   

  1. Division of Nephrology & Blood Purification Center of Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080 China
  • Received:2010-09-25 Revised:1900-01-01 Online:2011-02-12 Published:2011-02-12

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摘要： 目的 探讨超滤速度对终末期糖尿病肾病患者维持性血液透析中发生低血压的影响情况。 方法 选择维持性血液透析的终末期糖尿病肾病患者73例，按病情需要非随机地选择不同的透析模式、透析器、血流量及超滤速度，比较透析中低血压的发生率。 结果 个体化超滤速度≤10 ml/(kg•h)者与＞10 ml/(kg•h)者低血压的发生率分别为19.8%和25.5%，差异有统计学意义( 2 =6.590,P= 0.010)；多变量logistic回归模型中，个体化超滤速度是糖尿病肾病患者透析中发生低血压的一个独立危险因素。 结论 控制个体化超滤速度可有效地降低糖尿病肾病患者血液透析中低血压的发生率，提高血液透析的耐受性。

关键词: 糖尿病肾病, 血液透析, 低血压, 个体化超滤速度

Abstract: Objectives To evaluate the effect of ultrafiltration rate on the hypotension during hemodialysis session in patients with end stage diabetic nephropathy. Methods Seventy-three patients with end stage diabetic nephropathy receiving maintenance hemodialysis were selected in the study. They were treated with different dialysis modality, dialyzer, blood flow and ultrafiltration rate according to the individual condition. The occurrence of hypotension during hemodialysis session was analyzed. Results The intradialytic hypotension rate was 19.8% in patients with the individual ultrafiltration rate <10 ml/kg/h, and was 25.5% in patients with the rate >10ml/kg/h. Logistic regression analysis indicated that the individual ultrafiltration rate was an independent risk factor for intradialytic hypotension in patients with end stage diabetic nephropathy receiving maintenance hemodialysis. Conclusion A lower individual ultrafiltration rate can effectively reduce the occurrence of hypotension and can improve the tolerance to hemodialysis in patients with end stage diabetic nephropathy.

Key words: Hemodialysis, Hypotension, Individual ultrafiltration rate