透析过程中进食量对血透患者血压影响的初步观察被引量：8

Effect of food intake on blood pressure during hemodialysis

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摘要目的探讨血液透析中进食量对透析中血压变化的影响。方法连续观察36例稳定的血液透析患者的3次独立透析过程(n=108),计算透析中进食量(FI)、体重相对进食量(FI/BW)、超滤相对进食量(FI/UF),记录透析前血压及透析中每小时血压,分析患者进食量与血压的关系及与发生低血压的关系,并对引起透析低血压的可能因素进行多因素Logistic回归分析。结果所有透析次患者FI平均为(0.11±0.30)kg,收缩压(SBP)平均(126±29)mmHg,舒张压(DBP)平均(65±15)mmHg,平均动脉压(MAP)平均(83±18)mmHg。FI、FI/BW及FI/UF与患者SBP、DBP及MAP之间均无相关性。54例次患者发生低血压(50%),发生低血压者与未发生低血压者平均FI、平均FI/BW及平均FI/UF之间均无显著性差异。糖尿病及超滤量较大是发生透析低血压的危险因素。结论稳定的血透患者在透析过程中进食对血压无明显影响,糖尿病及超滤量较大是发生透析低血压的危险因素。 Objective To investigate the effect of food intake during hemodialysis on the change of blood pressure. Methods Three consecutive HD runs in 36 stable HD patients （n=108）were studied. Food intake （FI）, body weight controlled FI（FI/BW） and ultrafiltration controlled FI（FI/UF） were calculated. The blood pressure before and during hemodialysis were recorded. The correlation of FI with blood pressure and with hypotension was analyzed. Binary logistic regression was used to assess the factors related to intradialytic hypotension. Results The mean FI was （0.11±0.30） kg.The mean systolic blood pressure（SBP） was （126±29） mmHg, mean diastolic blood pressure（DBP） was （65±15） mmHg, mean MAP was （83±18） mmHg. FI, FI/BW and FI/UF were not correlated with either SBP, DBP or MAP. Patients experienced hypotension in 54 dialysis runs （50%）.There was no significant difference of mean FI, FI/BW and FI/UF in runs with hypotension with those without hypotension. Diabetes and large ultrafiltration were risk factors of intradialytic hypotension. Conclusions FI within a certain range has no significant impact on blood pressure and it does not correlate significantly with dialysis hypotension. Diabetes and large ultrafiltration are risk factors of intradialytic hypotension.

作者张国娟黄雯陈燊

机构地区首都医科大学附属北京同仁医院肾内科

出处《北京医学》 CAS 2010年第4期275-278,共4页 Beijing Medical Journal

关键词血液透析血压低血压进食 Hemodialysis Blood pressure Hypotension Food intake

分类号 R692.5 [医药卫生—泌尿科学]

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1Christner H, Riley M. Should patients eat during hemodialysis treatments? Nephrot Nurs J,2008,35:203-204.
2林善谈.当代肾脏病学.上海科技教育出版社.2001:837.
3Barakat MM, Nawab ZM, Yu AW, et al. Hemodynamic effects of intradialytic food ingestion and the effects of caffeine. J Am Soc Nephrol,1993,3:1813-1818.
4Strong J, Biurgett M, Buss ML, et al. Effects of calore and fluid intake on adverse events during hemodialysis. J Ren Nut,2001,11: 97-100.
5邹平华,易启莲.进食在血液透析中对血压的影响[J].实用中西医结合临床,2005,5(3):74-74. 被引量：10
6Sivalingam M, Banerjee A, Nevett G, et al. Haemodynamic effects of food intake during haemodialysis. Blood Purif,2008,26: 157-162.
7Benaroia M, Iliescu EA. Oral intake during hemodialysis: is there association with intradialytic hypotension? Hemodial Int,2008,12:62-65.
8Leunissen KM, Kooman JP, van der Sande FM, et al. Hypotension and ultrafiltratian physiology in dialysis. Blood Purif,2000, 18:251-254.
9Gabrielli D, Krystal B, Katzarski K, et al. Improved intradialytic stability during haemodialysis with blood volume-controlled ultrafiltration. J Nephrol,2009,22:232-240.
10Davenport A, Cox C, Thuraisingham R. Blood pressure control and symptomatic intradialytic hypotension in diabetic haemodialysis patients: a cross-sectional survey. Nephron Clin Pract,2008,109:c65-71.