摘要
目的了解维持性血液透析患者在透析过程中眼压的变化规律,并比较血液透析(HD)及血液滤过(HF)2种不同血液净化方式对眼压的影响。方法选择我院维持性血液透析患者共78例,分为血液透析组(n=63)和血滤过组(n=15)。记录所有患者治疗前后的收缩压及舒张压,计算平均动脉压。记录脱水量。测定所有患者治疗前后及治疗2h的卧位眼压及治疗前后血渗透压、血红蛋白、红细胞压积、血肌酐、血尿素氮、血糖、血钠的水平。采用t检验及Pearson相关分析进行统计学处理。结果与治疗前相比,两组患者治疗后收缩压及平均动脉压均明显下降。2组患者治疗过程中眼压变化均是先上升后下降,治疗后眼压低于治疗前水平。血液透析组治疗后眼压明显低于治疗中(P<0.01),而血液滤过组变化无统计学差异。2组间各理化指标的变化率比较仅Scr与BUN有明显统计学差异(P<0.01),血液滤过组低于血液透析组,余均无明显差异。双眼压的下降率与脱水量之间呈明显正相关关系(r分别为0.305、0.343,均P<0.05)。结论 2种治疗方式治疗过程中眼压的变化均是先升高后下降,治疗结束后眼压低于治疗前水平,血液透析治疗中眼压升高的更明显,而血液滤过治疗中眼压变化更稳定,提示血液滤过治疗血流动力学更稳定,对眼压的影响也较小。
Objective To observe the change pattern of intraocular pressure and the effect of hemodial- ysis and hemofiltration on intraocular pressure in maintenance hemodialysis （MHD） patients. Methods A total of 78 MHD patients treated in Beijing Hospital were divided into hemodialysis group （n=63） and hemo- filtration group （n=15）. Systolic and diastolic blood pressure and the derived average artery pressure were measured before and after dialysis. The dehydration volume after dialysis was calculated. Intraocular pressure at supine position was recorded before dialysis, after the initiation of dialysis for 2 hours, and after dialysis. Osmotic pressure, hemoglobin, hematocrit, serum creatinine （Scr）, blood urea nitrogen （BUN）, blood glucose and sodium were assayed before and after dialysis, t-test and Pearson correlation analysis were used for statis- tical analyses. Results Systolic blood pressure and average artery pressure decreased remarkably after dialy- sis in both groups. Intraocular pressure increased at the beginning of dialysis then decreased afterwards to a level lower than that before dialysis in both groups. Intraocular pressure after the treatment was significantly lower than that during dialysis in hemodialysis group （P〈0.01）, but was unchanged in hemofiltration group. Changes of Scr and BUN after dialysis were significantly higher in hemodialysis group than in hemofiltration group （P〈0.01）, but changes of other blood biochemistry parameters were similar between the two groups. The decrease of intraocular pressure in right and left eyes was positively correlated with the dehydration vol- ume after dialysis （r=0.305 and 0.343, respectively; P〈0.05）. Conclusions Intraocular pressure increased at the beginning of dialysis then decreased afterwards in both groups. Intraocular pressure at the end of dialysis was lower than that before dialysis. Intraocular pressure during dialysis increased more in hemodialysis group and stabilized significantly in hemofiltration group, suggesting that hemofiltration resulted in less hemody- namics disturbances and thus less intraocular pressure changes.
出处
《中国血液净化》
2015年第6期328-331,共4页
Chinese Journal of Blood Purification
基金
国际多中心研究(BJ-2012-43)
关键词
血液透析
血液滤过
眼压
Hemodialysis
Hemofiltration
Intraocular pressure
