【摘要】 目的探讨血液灌流对血管活性物质的影响及临床改善。方法选30例维持性血液透析患者,采用自身对照法,行血液透析(HD)串联血液灌流(HP)治疗设为HD+HP组,行常规血透设为HD组。分别测定两种治疗前后的血浆内皮素(ET)、一氧化氮(NO)、血管紧张素Ⅱ(ATⅡ)、肾素活性(PRA)水平。观察灌流后患者高血压改善情况。结果1)HD+HP组治疗后PRA升高(P<0.05);ET、NO均显著下降(P<0.01);ATⅡ稍有下降,但无统计学意义(P>0.05)。2)HD组治疗后PRA、ATⅡ均显著升高(P<0.01);而NO显著下降(P<0.01);ET略微下降,但无显著差异(P>0.05)。结论常规血透可以引起PRA、ATⅡ缩血管物质的水平升高,起扩张血管作用的NO下降,与患者透析后血压升高有一定联系。而行HD+HP治疗可降低ET、ATⅡ水平,且NO下降程度相对小,故能改善透析后高血压情况,减少并发症。更多还原

【Abstract】 Objective To investigate the effect and clinical significance of hemoperfusion(HP) on vasoactive material.Methods 30 patients treated by maintenance hemodialysis which were classified into two groups enrolled in this self-controlled prospective study. HD+HP group was given the treatment of combined hemodialysis-hemoperfusion, HD group with the treatment of single hemodialysis. The plasma levels of endothelin, nitric oxide, angiotensin-Ⅱand plasma renin activity were detected before and after the treatment. Results 1) After the treament of combined hemodialysis-hemoperfusion,the level of plasma renin activity were significantly increased (P<0.05)and the plasma levels of endothelin and nitric oxide were significantly decreased(P<0.01),but the plasma levels of angiotensin-II showed no statistically significant difference(P>0.05).2) After the treatment of hemodialysis, the level of plasma renin activity and angiotensin-Ⅱ were significantly increased (P<0.01), the plasma levels of nitric oxide were significantly decreased(P<0.01) and the change of endothelin was not statistically different. Conclusion The treatment of combined hemodialysis-hemoperfusion can safely and effectively clear the plasma levels of nitric oxide and endothelin,so it is beneficial to lower blood pressure and make up a deficit of single hemodialysis.更多还原