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- 저자 : 곽남주(Nam Ju Kwack) (검색결과 1 건)
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혈액투석 환자에서 활동중혈압을 이용한 투석간 혈압과 수시혈압과의 관계 및 일중 변동에 관한 연구
김혜영(Hye Young Kim),곽남주(Nam Ju Kwack),박남규(Nam Kyu Park),최기원(Ki Won Choi),김동운(Dong Woon Kim),조명찬(Myeong Chan Cho),이상도(Sang Do Lee),윤세진(Sei Jin Yoon),김승택(Seung Taik Kim),엄재호(Jae Ho Earm),남기병(Kee Byung Na 대한내과학회 1996 대한내과학회지 Vol.50 No.4
N/A Objectives: The pre, post and intradialytic blood pressure are used as the criteria of antihypertensive medication in hemodialysis patients but extracellular volume expansion, vasoactive substances released during ultrafiltration and removal of catecholamine make casual blood pressure inaccurate. Furthermore there are reports of the loss of normal diumal blood pressure variation in hemodialysia patients. So we performed this study to evaluate the relationship between interdialytic blood pressure and casual blood pressure measured during dialysis and to find the most representative casual blood pressure in hemodialysis patients. In addition the diurnal blood pressure variations of hemodialysis patients were observed. Methods : We measured interdialytic blood pressure using 24 hour ambulatory blood pressure monitoring(AHPM) and casual blood pressure in the day of dialysis in 21 hemodialysis patients. The increase of body weight during interdialytic period was also recorded. Blood pressure was monitored every 15 min for 24 hours in 21 hemodialysis patients and 50 age and sex matched normal controls. The day-night blood pressure difference was compared between hemodialysis patients and normal controls. Results: 1) The casual pre, intra, postdialytic systolic blood pressure(165.2±26.7 mmHg, 152.7±21.2 mmHg, 160.9±22.5 mmHg, respectively) were significantly higher than interdialytic ambulatory systolic blood pressure (147.9±19.4 mmHg)(p<0.05). 2) The casual pre, intra, postdialytic diastolic blood pressure(94.5±14.8 mmHg, 89.5±15.4 mmHg, 92.4±14.8 mmHg, respectively) were significantly higher than interdialytic ambulatory diastolic blood pressure(77.8±12.2 mmHg)(p<0.05). 3) There were significant relationship between casual pre, intra, postdialytic systolic pressure and interdialytic ambulatory systolic pressure(p<0.01). Correlation coefficients were ranged from 0.67 to 0.78. Hut the only casual postdialytic diastolic pressure was significantly correlated with interdialytic ambulatory diastolic pressure(p<0.01). Correlation coefficients were ranged from 0.56 to 0.58. 4) In normal controls, the daytime blood pressure was significantly higher than nighttime blood pressure(p<0,01) and the day-night difference was 7.1±9.6 mmHg in systolic pressure, and 2.2±6.3 mmHg in diastolic pressure. Hut in hemodialysis patients, that was reversed (p<0.01) and the day- night difference was -4.5±11.7 mmHg in systolic pressure and -1.8±10.2 mmHg in diastolic pressure. Conclusion: The blood pressure measured in the day dialysis was significantly higher than interdialytic ambulatory blood pressure. And the postdialytic blood pressure was significantly related to interdialytic ambulatory blood pressure in both systolic and diastolic pressure. Normal diurnal blood pressure variation was lost in hemodialysis patients.
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