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目的:探讨维持性血液透析并发低血压的相关因素及机理。方法:对82例醋酸盐血液透析超过1个月的慢性肾功能衰竭(CRF)患者进行统计学分析。结果:11486例次透析并发低血压236次,绝大多数低血压发生在超滤量>2L及透析时间>2h时。结缔组织病相关性肾损害、血红蛋白≤70g/%、左室舒张末期直径(LVEL)≥55mm者,低血压发生率高于其他病因的肾损害、血红蛋白>70g/L、LVED<55mm组。结论:透析低血压是多因素作用的结果,包括超滤量及透析时间,醋酸盐对心血管的抑制作用,结缔组织病引起的血管炎降低血管的顺应性,严重贫血及心功能不全等。
Objective: To investigate the related factors and mechanism of maintenance hemodialysis complicated hypotension. Methods: A total of 82 patients with chronic renal failure (CRF) who underwent hemodialysis for acetate more than one month were analyzed statistically. Results: Of 11486 dialysis patients, 236 were complicated by hypotension, most of which occurred when ultrafiltration volume> 2L and dialysis time> 2h. Associated renal damage of connective tissue disease, hemoglobin ≤ 70g /%, left ventricular end diastolic diameter (LVEL) ≥ 55mm, hypotension was higher than other causes of renal damage, hemoglobin> 70g / L, LVED <55mm group. CONCLUSIONS: Dialysis hypotension is the result of a multifactorial effect, including ultrafiltration and dialysis duration, inhibition of cardiovascular effects by acetate, vasculitis associated with connective tissue disease, reduced vascular compliance, severe anemia, and cardiac insufficiency .