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中华肾病研究电子杂志 ›› 2014, Vol. 03 ›› Issue (03) : 118 -122. doi: 10.3877/cma.j.issn.2095-3216.2014.03.001

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血液透析患者高血压诊治新进展
丁小强1,(), 余金波1   
  1. 1.200032 上海,复旦大学附属中山医院肾内科
  • 出版日期:2014-06-15
  • 通信作者: 丁小强
  • 基金资助:
    上海市卫生局新百人计划( XBR2011003)

Advances in the diagnosis and treatment of patients with hemodialysis-associated hypertension

Xiaoqiang Ding1,(), Jinbo Yu1   

  1. 1.Department of Nephrology, Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032, China
  • Published:2014-06-15
  • Corresponding author: Xiaoqiang Ding
引用本文:

丁小强, 余金波. 血液透析患者高血压诊治新进展[J/OL]. 中华肾病研究电子杂志, 2014, 03(03): 118-122.

Xiaoqiang Ding, Jinbo Yu. Advances in the diagnosis and treatment of patients with hemodialysis-associated hypertension[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2014, 03(03): 118-122.

血液透析患者高血压患病率高,对预后有显著影响。 由于血液透析患者的血压随透析周期容量的周期性变化而呈现周期性变化,给血液透析患者血压的准确评价带来困难。 应重视不同时间点血压测量对血液透析患者血压评价的重要性。 血液透析患者血压控制的靶目标需依据患者的具体情况决定,尤其须考虑患者容量和心脏状态。 在治疗方面,容量控制与稳定是关键。 降压药的选择应考虑透析对药物的清除情况,长效钙通道阻滞剂、血管紧张素受体阻滞剂和αβ 受体阻滞剂类药物在血液透析高血压治疗中占有重要地位。

Hypertension affects the majority of hemodialysis patients and is a risk factor for mortality. However, accurate assessment of blood pressure for hemodialysis patients is difficult as the blood pressure changes periodically with the periodic change of dialysis cycle volume. Attention should be paid to the importance of blood pressure measuring at different time points for the evaluation of blood pressure in hemodialysis patients. The target of blood pressure control in hemodialysis patients should be based on specific conditions of the patients, especially the patients' volume status and cardiac function. The control and maintenance of patients' volume are key factors of the treatment. The choice of anti-hypertensive drugs should be made according to the different rates of drugs clearance by hemodialysis. Long-acting calcium channel blockers, angiotensin receptor blockers, and α/β receptor blockers are important in the treatment of hemodialysis-associated hypertension.

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