ABSTRACT
Objective To compare the clinical effects between the two-level ladder ultrafiltration and sequential dialysis for hemodialysis patients with excessive water retention.Methods According to our hospital standard,23 patients with water retention during treatment with dialysis from January 2010 to September 2011 were selected.And they conducted a total of 198 dialysis.Both the two-level of high-level segment and sequential ultrafiltration step dialysis were set for 1 hour.Ultrafiltration accounted for one-third of the total,and the remaining two-thirds of the amount of ultrafiltration was completed in the remaining time.The blood pressure,ultrafiltration volume completed,plasma osmotic pressure,detection of vascular access pressure,and other observed indicators during dialysis were compared.Results The occurrence of hypotension and muscle spasms in two-level ladder ultrafiltration was slightly more than that in sequential dialysis,ultrafiltration volume completed actually in two-level ladder ultrafiltration was a little less than sequential dialysis.However,the difference was not statistically significant ( P ＞ 0.05 ).It took more time during sequential dialysis simple ultrafiltration,occasionally dialysis fluid stopped flowing and dialyzer and the trail tube lack of incubation,and some patients could not adapt to it.Amount of heparin( [7.48 ± 1.73 ] mg/h vs[6.25 ± 1.36] mg/h,t =5.374,P ＜ 0.01 ),venous pressure ( [ 128.62 ± 10.53 ] mm Hg vs [ 96.35 ± 11.84 ] mm Hg,t =20.166,P ＜ 0.01 ),trausmembrane pressure( [ 236.84 ± 23.65 ] mm Hg vs [ 175.94 ± 24.72] mm Hg,t =17.516,P ＜ 0.01 ) were significantly higher than those in the high level of ultrafiltration period.Mean arterial pressure ( MAP ) ( [ 100.48 ± 5.78 ] mm Hg vs [ 102.54 ± 5.39 ] mm Hg,t =2.571,P ＜ 0.05 ) and plasma osmotic pressure ( [ 311.42 ± 7.36] mOsm/( kg · H2O ) vs [ 3 1 7.31 ± 6.89 ] mOsm/( kg · H2O ),t =5.774,P ＜ 0.01 ) in high level period were significantly lower than those in the singal ultrafiltration period,and the MAP difference was higher than that in the singal ultrafiltration period ( [ 11.46 ± 6.53 ] mm Hg vs [ 9.42 ± 5.46 ] mm Hg,t =2.385,P ＜ 0.05 ).There is less symptomatic hypotension and other adverse reactions.Conclusion Two dialysis ultrafiltration method can both be used for patients with excessive water retention,they can reduce the ultrafiltraion complications and achieve ultrafiltration targets.Two-level ladder ultrafiltration with dialysis and ultra.filtration unity is more likely to be adopted by the clinic.
ABSTRACT
Objective To observe the curative effect that losartan potassium combined with enalapril used in treating Ⅳ phase diabetic nephropathy(DN). Methods Divided 74 Ⅳ phase DN suffers into 3 groups randomly.Losartan group:taken losartan potassium lablets 100 mg once every day orally,enalapril group:taken enalapril tablets 10 mg once every day orally,consociation group:taken the two drugs above ai one time with the same dosage.The treatment in the 3 groups were all above 3 years.monitoring the 24-hour albuminuria and SCr back and forth the treatment.Results It worthed statistics meaning that the 24-hour albuminuria in the 3 groups all declined(P＜0.05).The effect of consociation group did better(P＜O.01).In term of SCr,it declined in the consociation group worthed statisties meaning only.Conclusion The consociation application with losartan potassium and enalapril can control the proteinuria of Ⅳ phage DN suffers efficiently as well as defer process of kidney diseases.
ABSTRACT
Objective It has been known that hepatopulmonary syndrome(HPS) is related to the imbalance between vasoconstrictors and vasodilators. The aim of the study is to examine the levels of plasma calcitonin gene related peptide (CGRP) and endothelin(ET) in patients with HPS for exploring their roles in HPS formation. Methods The levels of CGRP and ET were measured by radioimmunoassay in 16 cases of HPS, 30 cases of liver cirrhosis without HPS and 15 normal controls. Results The levels of plasma CGRP ((65?15)pg/ml) and ET((78?21)pg/ml) in 16 cases of HPS were significantly higher than those in liver cirrhosis (CGRP (51?15) pg/ml, ET (60?14) pg/ml) and in healthy controls (CGRP (32?12) pg/ml, ET (36?11) pg/ml) ( P 0.05). Conclusions The increase of plasma CGRP and ET is closely associated with the intrapulmonar vascular dilation of HPS and hypoxemia. The levels of plasma CGRP and ET in liver cirrhosis were significantly higher than those in healthy controls ( P