【摘要】目的本文研究应用杂合式血液净化方式对维持性血液透析(maintenance hemodialysis，MHD)患者透析中血压变异性(blood pressure variability，BPV)的影响。方法选取解放军第150中心医院血液透析中心MHD 患者40 例。首先应用普通血液透析治疗8 周，然后应用杂合式血液净化治疗8 周，记录每周第1 次透析前、透析过程中每小时及结束后所有血压值，计算收缩压(systolic blood pressure，SBP)、舒张压(diastolic blood pressure，DBP)的平均值和标准差(standard deviation，SD)，以变异系数(coefficient of variation，CV)表示透析中收缩压和舒张压BPV。计算比较不同治疗模式透析中BPV 的差异。结果共40 例患者纳入本次研究，常规血液透析治疗中收缩压CV 为6.45±1.78，舒张压CV 为4.85±2.12。进行杂合式血液净化治疗后收缩压CV 为2.97±0.82，舒张压CV 为1.67±0.43。两组对比有统计学差异(SBP-CV: t=3.894,P =0.004)。常规血液透析治疗和杂合式血液净化治疗后SBP-SD、DBP-SD 两组对比有统计学差异(DBP-CV:t = 2.326,P = 0.0237)，而平均SBP、平均DBP 比较差异无统计学差异(P＞0.05)。结论患者在应用杂合式血液净化治疗后，无论是透析中收缩压BPV 亦或是舒张压BPV 均有明显改善，值得广泛推广和深入研究。

Objective To explore the clinical effect of heterozygous blood purification on intradialytic blood pressure variability. Method Forty maintenance hemodialysis (MHD) patients with stable disease status were recruited in Hemodialysis Center of the 150th PLA Hospital. Patients were treated with routine hemodialysis
for 8 weeks followed by heterozygous blood purification for 8 weeks. Blood pressure at the first hemodialysis session of every week was recorded. The mean and standard deviation of systolic and diastolic pressure were calculated. Coefficient of variation was used to express blood pressure variation (BPV). BPV
under different treatment stages were calculated and compared. Result A total of 40 patients were enrolled. In routine hemodialysis stage, intradialytic systolic BPV was 6.45±1.78, and intradialytic diastolic BPV was 4.85±2.12; in heterozygous blood purification stage, intradialytic systolic BPV was 2.97±0.82 (P＜0.05), and intradialytic diastolic BPV was 1.67±0.43 (P＜0.05). The mean systolic and diastolic blood pressure changed insignificantly between the two treatment stages (P>0.05). Conclusion After heterozygous blood purification, intradialytic systolic BPV and diastolic BPV reduced significantly. This blood purification method needs to be further studied.