JASN：血液透析与血压管理！

2017-12-09 xing.T MedSci原创

虽然研究人员得到了一个可能安全的结果，但试验规模较小，持续时间较短，却无法得出明确的结论。考虑到血液透析患者主要心血管不良事件的高风险，需要进行全面的试验来评估这一人群中强化高血压控制的潜在益处。

血液透析患者的最佳的血压目标值尚不清楚。近日，肾脏病领域权威杂志Journal of the American Society of Nephrology上发表一篇研究文章，研究人员将126例高血压血液透析患者随机分为透析前收缩压为110-140mmHg（强化降压组）或155-165mmHg（标准治疗组）。

该研究的主要目的是评估治疗方案的可行性和安全性，次要目标是评估左心室质量的变化。中位随访时间为365天，在标准治疗组，两周的平均收缩压在干预期间没有明显变化，但在强化降压组，收缩压从基线的160mmHg下降至4.5个月后的143mmHg。从4到12个月，组间收缩压的平均差异为12.9mmHg。强化降压组中有四例死亡，标准治疗组中有一例死亡。强化降压组与标准治疗组相比，主要不良心血管事件、住院和血管通路血栓形成的发病率比值分别为1.18（0.40-3.33）、1.61（0.87-2.97）和3.09（0.96-8.78）。强化治疗组和标准治疗组左心室质量也有类似的中位数变化（95%可信区间）分别为-0.84（-17.1至10）和1.4（-11.6至10.4）g。

虽然研究人员得到了一个可能安全的结果，但试验规模较小，持续时间较短，却无法得出明确的结论。考虑到血液透析患者主要心血管不良事件的高风险，需要进行全面的试验来评估这一人群中强化高血压控制的潜在益处。

原始出处：

Dana C. Miskulin,et al. BP in Dialysis: Results of a Pilot Study.JASN,2017, http://jasn.asnjournals.org/content/early/2017/12/06/ASN.2017020135.abstract#aff-1

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2018-05-07 chenhongpeng

#ASN#

61 0
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2017-12-11 habb

#血液透析#

57 0
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2017-12-11 12498e5fm12(暂无昵称)

#血压管理#

66 0
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2017-12-09 惠映实验室

学习了.谢谢.

83 0

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