国际移植与血液净化杂志
國際移植與血液淨化雜誌
국제이식여혈액정화잡지
INTERNATIONAL JOURNAL OF TRANSPLANTATION AND HEMOPURIFICATION
2014年
1期
22-24
,共3页
吴胜利%张桂芝%李寒%王世相
吳勝利%張桂芝%李寒%王世相
오성리%장계지%리한%왕세상
高钾血症%透析间期%血液透析
高鉀血癥%透析間期%血液透析
고갑혈증%투석간기%혈액투석
Hyperpotassemia%Intermittent%Hemodialysis
目的 探讨维持性血液透析者不同透析间期高钾血症发生情况及其危险因素.方法 纳入接受每周3次维持性血液透析者60例,采用自身前后对照设计进行研究.取其透析间期44h和68h透析前后静脉血,检测血清钾、钠、钙、尿素氮、肌酐、二氧化碳结合力,采用t检验或卡方检验进行组间数据比较.结果 (1)44 h透析间期组透析前尿素氮、血肌酐、血钠和血钾水平均明显低于68h透析间期组,差异具有统计学意义.按照血钾水平＜5.5 mmol/L、5.5～6.4 mmol/L、＞6.5 mmol/L进行分层,44h透析间期组血钾水平＜5.5 mmol/L、5.5～6.4 mmol/L、＞ 6.5 mmol/L者所占比例分别为76.6％(46/60)、23.3％(14/60)、0(0/60);而68h透析间期组血钾水平＜ 5.5 mmol/L、5.5～6.4 mmol/L、＞6.5 mmol/L者所占比例分别为51.6％ (31/60)、38.3％(23/60)、10.0％ (6/60),两组差异有统计学意义(P值分别为0.004、0.001、0.001).(2)透析前血钾水平与二氧化碳结合力呈负相关(r=-0.311,P=0.001).结论 维持性血液透析者采用68 h透析间期后高钾血症的发生率较高,透析前高钾血症的发生与代谢性酸中毒和摄入高钾食物相关.
目的 探討維持性血液透析者不同透析間期高鉀血癥髮生情況及其危險因素.方法 納入接受每週3次維持性血液透析者60例,採用自身前後對照設計進行研究.取其透析間期44h和68h透析前後靜脈血,檢測血清鉀、鈉、鈣、尿素氮、肌酐、二氧化碳結閤力,採用t檢驗或卡方檢驗進行組間數據比較.結果 (1)44 h透析間期組透析前尿素氮、血肌酐、血鈉和血鉀水平均明顯低于68h透析間期組,差異具有統計學意義.按照血鉀水平＜5.5 mmol/L、5.5～6.4 mmol/L、＞6.5 mmol/L進行分層,44h透析間期組血鉀水平＜5.5 mmol/L、5.5～6.4 mmol/L、＞ 6.5 mmol/L者所佔比例分彆為76.6％(46/60)、23.3％(14/60)、0(0/60);而68h透析間期組血鉀水平＜ 5.5 mmol/L、5.5～6.4 mmol/L、＞6.5 mmol/L者所佔比例分彆為51.6％ (31/60)、38.3％(23/60)、10.0％ (6/60),兩組差異有統計學意義(P值分彆為0.004、0.001、0.001).(2)透析前血鉀水平與二氧化碳結閤力呈負相關(r=-0.311,P=0.001).結論 維持性血液透析者採用68 h透析間期後高鉀血癥的髮生率較高,透析前高鉀血癥的髮生與代謝性痠中毒和攝入高鉀食物相關.
목적 탐토유지성혈액투석자불동투석간기고갑혈증발생정황급기위험인소.방법 납입접수매주3차유지성혈액투석자60례,채용자신전후대조설계진행연구.취기투석간기44h화68h투석전후정맥혈,검측혈청갑、납、개、뇨소담、기항、이양화탄결합력,채용t검험혹잡방검험진행조간수거비교.결과 (1)44 h투석간기조투석전뇨소담、혈기항、혈납화혈갑수평균명현저우68h투석간기조,차이구유통계학의의.안조혈갑수평＜5.5 mmol/L、5.5～6.4 mmol/L、＞6.5 mmol/L진행분층,44h투석간기조혈갑수평＜5.5 mmol/L、5.5～6.4 mmol/L、＞ 6.5 mmol/L자소점비례분별위76.6％(46/60)、23.3％(14/60)、0(0/60);이68h투석간기조혈갑수평＜ 5.5 mmol/L、5.5～6.4 mmol/L、＞6.5 mmol/L자소점비례분별위51.6％ (31/60)、38.3％(23/60)、10.0％ (6/60),량조차이유통계학의의(P치분별위0.004、0.001、0.001).(2)투석전혈갑수평여이양화탄결합력정부상관(r=-0.311,P=0.001).결론 유지성혈액투석자채용68 h투석간기후고갑혈증적발생솔교고,투석전고갑혈증적발생여대사성산중독화섭입고갑식물상관.
Objective To investigate the incidence of hyperkalemia and its risk factors in maintenance hemodialysis (MHD) patients with different intermittent.Methods A total of 60 MHD patients undergoing 3 times per week dialysis were studied,and the dialysis intermittent was 44 and 68 hours,respectively.Serum levels of potassium,sodium,calcium,usea nitrogen (BUN),serum creatinine (SCr) and carban dioxide-combining power (CO2 CP) were determined before and after the dialysis.Student's t test or Chi-square test was used for data analysis.Results There were significant differences of BUN,SCr,serum sodium and potassium between the 44-and 68-hour groups before hemodialysis (all P values were 0.000).According to serum potassium (＜ 5.5 mmol/L,5.5-6.4 mmol/L,＞ 6.5 mmol/L),the morbidities of the 44-hour group were 76.6％ (46/60),23.3％ (14/60) and 0 (0/60),respectively; the morbidities of the 68-hour group were 51.6％ (31/60),38.3％ (23/60) and 10.0％ (6/60),respectively (P values were 0.004,0.001 and 0.001,respectively).In addition,there was negative correlation between CO2 CP serum potassium level before hemodialysis (r =-0.311,P =0.001).Conclusion Serum potassium of the MHD patients with 68-hour intermittent could be higher than those with 44-hour intermittent.It is essential for MHD patients to rectify acidosis,strengthen self-mangement and apply selfeducation in the process of hemodialysis.
