CAJ | 학술논문

目的探讨血液透析患者超滤与血压昼夜节律及心脏结构和功能的关系.方法维持性血液透析患者42例,对患者加强透析超滤4周,分别检测超滤前后血肌酐、尿素氮、钾、钠及动态血压和心脏彩超.结果根据24 h动态血压监测发现血液透析患者非杓型血压比例明显升高;超滤前后血压节律和心脏结构有显著性改变(P<0.05),平均每次超滤量与血压和心脏结构变化具有相关性(P<0.05).结论血液透析患者的夜间高血压与高血容量有关,通过加强超滤可有效控制夜间高血压并改善心功能.
목적 탐토혈액투석환자초려여혈압주야절률급심장결구화공능적관계.방법 유지성혈액투석환자42례,대환자가강투석초려4주,분별검측초려전후혈기항、뇨소담、갑、납급동태혈압화심장채초.결과 근거24 h동태혈압감측발현혈액투석환자비표형혈압비례명현승고;초려전후혈압절률화심장결구유현저성개변(P<0.05),평균매차초려량여혈압화심장결구변화구유상관성(P<0.05).결론 혈액투석환자적야간고혈압여고혈용량유관,통과가강초려가유효공제야간고혈압병개선심공능.
Objective To investigate the relationship among ultrafiltration (UF), diurnal rhythm of blood pressure (BP) and cardiac structure and function in hemodialyzed(HD) patients. Method 42 hemodialyzed patients were studied. Intensified UF during routine HD were given to them for 4 weeks. Before and after 4 weeks, everyone received 24 hours ambulatory blood pressure monitoring and cardiac doppler and recorded diameter of left atrium (LAD) ,left ventricle (LVEDD), thickness of posterior wall of left ventricle during end stage of diastolic period (LVPWT) ,thickness of interventricular septum(IVST) ,ejection fraction (EF). Result In hemodialyzed patients, non-dipper hypertension was much more than dippers (P < 0.05). There was significant difference between nocturnal BP and cardiac structure before and after 4 weeks of hemodialysis ( P < 0.05 ). Conclusion Nocturnal hyperten- sion of hemodialyzed patients is related to hypervolemia. Intensive ultrafihration can improve nocturnal hypertension and eardiac function.