应用人体成分分析仪评估干体重对维持性血液透析患者顽固性高血压的影响

发布时间：2018-06-11 15:10

本文选题：人体成分分析 + 生物电阻抗　；参考：《实用医学杂志》2017年10期

【摘要】：目的:探讨通过人体成分分析评估体重对维持性血液透析患者顽固性高血压的影响。方法:纳入维持性血液透析伴顽固性高血压患者56例,随机分为两组,A组患者根据人体成分分析仪测量的结果调整超滤量达到干体重,B组患者由肾内科专科医生根据患者的体征、实验室检查和辅助检查的结果来评估患者的干体重,并逐渐下调至医生设定的干体重。记录患者干预前后24h动态血压、干体重下降值的变化以及透析过程中的不良反应。结果 A组患者与B组患者相比,干预后干体重下降值明显减低(3.87±1.49 vs.2.16±0.85,P0.05);A组患者与B组患者相比干预后收缩压、舒张压和平均动脉压均显著下降(139±19 vs.147±17;74±10 vs.85±11;94±13 vs.112±8,P0.05;干预后A组患者血压达标率明显高于B组(46.1%vs.23.1%,P0.05),两组患者在透析过程中不良反应发生情况差异无统计学意义。结论:临床医师根据临床表现评估干体重存在过高估计干体重的情况,而应用人体成分分析仪评估干体重更准确,有助于改善透析患者的顽固性高血压,并且未见明显的不良反应。
[Abstract]:Objective: to evaluate the effect of body weight on refractory hypertension in maintenance hemodialysis patients. Methods: 56 patients with maintenance hemodialysis and refractory hypertension were included. Two groups of patients were randomly divided into two groups: group A adjusted ultrafiltration to dry weight according to the results of body composition analyzer, and the patients in group B were evaluated by a specialist in renal medicine according to the results of the patients' physical signs, laboratory tests and auxiliary examinations. And gradually lowered to the doctor set dry weight. The changes of ambulatory blood pressure, dry weight loss and adverse reactions during dialysis were recorded before and after intervention. Results compared with group B, the dry weight loss value of group A was significantly lower than that of group B (3.87 卤1.49 vs.2.16 卤0.85%), and the systolic blood pressure of group A was significantly lower than that of group B. Diastolic blood pressure (DBP) and mean arterial pressure decreased significantly (139 卤19 vs.147 卤1774 卤10 vs.85 卤1194 卤13 vs.112 卤8 vs.112 P0.05), and the blood pressure of group A was significantly higher than that of group B (46.1vs.23.1V). There was no significant difference between the two groups in the incidence of adverse reactions during dialysis. Conclusion: according to the clinical manifestation, the clinicians have overestimated the dry weight, and it is more accurate to use the human body composition analyzer to evaluate the dry weight, which is helpful to improve the refractory hypertension in dialysis patients. There was no obvious adverse reaction.
【作者单位】：贵州省贵阳市第一人民医院肾脏内科;
【分类号】：R544.1;R692.5

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