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目的分析血液透析(HD)患者高血压发生的原因,总结有效防治措施。方法将我院2008年6月-2011年6月血液透析的79例患者,按血压情况分为血压控制良好组(n=38)和血压控制不良组(n=41)。记录两组患者年龄、透析龄、原发病、24h尿量、透析间期体重增加量、服用降压药种类、透析频率、促红细胞生成素(EPO)用量、胸腔积液、血液灌流(HP)情况;检测血红蛋白(Hb)、血浆白蛋白(Alb)、血Ca、血P、钙磷乘积(Ca×P)、尿素氮(BUN)、肌酐(Scr)及全段甲状旁腺激素(iPTH)水平,计算Kt/V。结果两组患者比较,服用降压药种类、透析间期体重增加量、血Ca、Ca×P、胸腔积液、HP、Kt/V、透析频率均存在显著差异(P<0.05)。结论降压药物、透析间期体重控制不良、胸腔积液、透析频率少、透析不充分、血Ca、Ca×P不达标、不定期HP治疗是HD患者高血压发生的主要原因。
Objective To analyze the causes of hypertension in hemodialysis (HD) patients and to summarize the effective prevention and treatment measures. Methods 79 cases of hemodialysis patients in our hospital from June 2008 to June 2011 were divided into two groups according to their blood pressure: normotensive group (n = 38) and poor blood pressure control group (n = 41). The age, dialysis age, primary disease, 24h urine volume, dialysis weight gain, type of antihypertensive drugs, dialysis frequency, EPO dosage, pleural effusion and hemoperfusion (Hb), serum albumin (Alb), blood Ca, blood P, Ca × P, BUN, Scr and iPTH ) Level, calculate Kt / V. Results There was significant difference (P <0.05) between the two groups of patients taking antihypertensive drugs, weight gain during dialysis, blood Ca, Ca × P, pleural effusion, HP, Kt / V and dialysis frequency. Conclusions Antihypertensive drugs, poor control of weight during dialysis, pleural effusion, low dialysis frequency, inadequate dialysis, unsatisfactory blood Ca and Ca × P, and irregular HP therapy are the main causes of hypertension in HD patients.