Dialysis fluid temperature and vasoactive substances during routine hemodialysis.
Dialysis fluid temperature and vasoactive substances during routine hemodialysis.
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常规血液透析期间透析液温度和血管活性物质。
DOI：
10.1097/00002480-199407000-00084
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发表时间：
1994
期刊：
影响因子：
4.2
通讯作者：
Hans Thysell
中科院分区：
文献类型：
--
作者：
Jörgen Hegbrant;Lena Mårtensson;Rolf Ekman;Anders Lassen Nielsen;Hans Thysell
冷血液透析（HD）期间血压稳定性更好。这主要归因于在寒冷期间比在温暖HD期间更明显的交感神经激活。作者研究了透析液温度对血管活性肽、去甲肾上腺素（NA）和肾素（PRA）的影响。10例血流动力学稳定的患者分别在两种透析液温度下透析240分钟：38.5 ℃（热HD = WHD）和34.5 ℃（冷HD = CHD）。WHD时血压下降（P <0.05），CHD时血压稳定。两种方案之间的血管收缩剂无差异。NA降低（P <0.05），PRA有增加的趋势（NS，由于统计学差异较大），而精氨酸加压素无变化。在CHD期间，神经肽Y（NPY）略有增加;然而，在WHD期间，NPY仅倾向于增加。然而，WHD和CHD后的相对NPY水平（基线水平的百分比）没有差异。两种治疗期间的血管扩张剂反应相似。降钙素基因相关肽无变化。胃动素开始时呈下降趋势，但随后升高（P <0.05）至基线水平。β-内啡肽（P <0.05）和P物质（P <0.01）含量升高。血管活性肠肽（VIP）最初升高（P <0.05），随后在治疗的剩余时间内呈下降趋势。作者得出结论，CHD期间血压稳定性更好。然而，这并没有反映在血管活性肽的血浆水平的差异上，他们也没有发现两种方案之间的交感神经驱动有任何差异。
Blood pressure stability is better during cold hemodialysis (HD). This has mainly been attributed to a more pronounced sympathetic activation during cold than during warm HD. The authors studied the effect of dialysate temperature on vasoactive peptides, noradrenaline (NA), and renin (PRA). Ten hemodynamically stable patients were dialyzed for 240 min with each of two dialysate temperatures: 38.5 degrees C (warm HD = WHD) and 34.5 degrees C (cold HD = CHD). A decrease (P < 0.05) in blood pressure occurred during WHD; however, during CHD, blood pressure was stable. There were no differences in vasoconstrictors between the two regimens. There was a decrease in NA (P < 0.05), a tendency of PRA to increase (NS owing to a large statistical spread), while arginine vasopressin was unchanged. During CHD, there was a small increase in neuropeptide Y (NPY); however, during WHD, NPY only tended to increase. However, the relative NPY levels (percent of baseline levels) after WHD and CHD did not differ. The vasodilator response was similar during both treatments. Calcitonin gene related peptide was unaltered. Motilin tended to decrease initially, but then increased (P < 0.05) to baseline levels. An increase occurred in beta-endorphin (P < 0.05) and substance P(P < 0.01). There was an initial rise (P < 0.05) in vasoactive intestinal peptide (VIP), followed by a tendency to decrease during the remainder of treatment. The authors concluded that blood pressure stability was better during CHD. However, this was not reflected by differences in plasma levels of the vasoactive peptides, nor did they find any difference in the sympathetic drive between the two regimens.