目的 探讨阿托伐他汀对血液透析治疗患者心功能及血清可溶性ST2与半乳糖凝集素3(Galectin-3)水平的影响,为透析相关治疗提供参考.方法 前瞻性选取2017年3月至2020年3月合肥市滨湖医院肾内科血液透析中心的维持性血液透析患者60例,采用随机数字表分成治疗组(n=30)与对照组(n=30).对照组患者在血液透析治疗中常规注射重组人促红细胞生成素并控制血压等,治疗组患者则在透析治疗同时予以口服阿托伐他汀(10～20 mg/d)治疗.2组均连续治疗3个月,治疗期均严密监测患者体征变化等.比较2组患者治疗前、治疗3个月后心功能指标[左室射血分数(LVEF)、心排血量(CO)以及室间隔舒张末期厚度(LVST)]、血清可溶性ST2、Galectin G3水平及不良反应发生情况.结果 治疗3个月后,治疗组患者的LVEF、CO水平[(5.00±0.64)L/min、(67.34±7.71)％]较治疗前[(4.10±0.42)L/min、(55.13±7.61)％]显著升高,且治疗组显著高于对照组[(4.20±0.24)L/min、(57.61±7.28)％],差异均有统计学意义(P<0.05);治疗前、治疗3个月后,2组LVST水平比较均无明显变化,差异无统计学意义(P>0.05).治疗3个月后,治疗组患者的血清可溶性ST2、Galectin-3水平[(12.74±7.36)、(6.34±4.20)ng/mL]均较治疗前[(22.09±8.83)、(12.62±6.54)ng/mL]显著下降,且治疗组显著低于对照组[(24.21±9.24)、(14.51±6.47)ng/mL],差异均有统计学意义(P<0.05).2组患者治疗中均无严重的用药不良反应发生,安全性高.结论 在血液透析治疗过程中,阿托伐他汀的应用能够有效降低血清可溶性ST2、Galectin-3水平,显著改善患者的心功能且用药安全性较高,具有一定的应用价值.

目的 探讨端侧吻合法建立前臂直径<2.0 mm头静脉血管动静脉内瘘(arteriovenous fistula,AVF)的效果,为预测直径<2.0 mm头静脉血管是否能建立AVF提供参考.方法 回顾性分析2018年1月至2019年9月在合肥市滨湖医院建立AVF并且留在血液净化中心透析的终末期肾脏病病人30例.根据术前超声测量头静脉管腔直径大小,分为观察组(头静脉血管直径<2.0 mm)和对照组(头静脉血管直径>2.0 mm),各15例.超声测量两组术前和术后的头静脉、桡动脉和术后瘘口直径和平均血流流速,记录首次上机透析时间,透析12周后采集透析时的血泵血流量、有效血流量和动脉压,评价AVF功能及成功率.结果 对照组均一次性成功建立AVF,成功率100％(15/15).观察组中12例一次性成功建立,1例二次手术后成功建立,1例术后12周后经球囊扩张后可以使用,1例选择颈内半永久管作为长期血管通路,首次成功率80％(12/15),总成功率93％(14/15).观察组和对照组首次使用时间分别为(40.14±13.26)d和(31.00±4.77)d,与对照组相比,观察组明显延后(P<0.05).术后4周观察组和对照组的瘘口直径分别为(3.41±0.08)mm和(4.15±0.65)mm,两组比较差异有统计学意义(P<0.05).术后4周观察组和对照组的头静脉直径分别为(3.87±0.81)mm和(4.74±0.99)mm,两组比较差异有统计学意义(P<0.05).透析12周后观察组和对照组透析时有效血流量分别为(247.8±20.60)mL/min和(263.60±22.59)mL/min,两组比较差异有统计学意义(P<0.05).结论 端侧吻合法在前臂位置同样适合建立头静脉管腔直径<2.0 mm病人的AVF,但需要较长的成熟期,成熟后基本不影响透析.

目的 观察雷公藤多苷对慢性肾炎患者炎性因子和肾功能的影响.方法 将72例慢性肾炎患者,随机分为试验组和对照组,各36例.对照组给予厄贝沙坦片150 mg·d-1,阿魏酸钠片50 mg,每天3次,口服;试验组在对照组的基础上给予雷公藤多苷片,每次20 mg,每天3次,口服.2组均连续治疗2个月.比较2组治疗前后炎性因子、肾功能和24 h尿蛋白定量.结果 治疗后,对照组与试验组血清白细胞介素-6(IL-6)含量分别为(3.22±2.92),(2.51±0.71)μg·L-1;血清肿瘤坏死因子-α(TNF-α)含量分别为(185.87±41.52),(115.47±35.53)μg·L-1;血肌酸酐(Scr)水平分别为(312.87±128.92),(262.28±139.68)μmol·L-1;血尿素氮(BUN)水平分别为(21.87±11.52),(15.23±7.53)mmol·L-1;血浆白蛋白含量分别为(29.87±8.42),(35.28±7.38)g·L-1;24 h尿蛋白定量分别为(4.48±2.82),(2.13±0.78)g,差异均有统计学意义(均P<0.05).治疗期间,对照组与试验组药物不良反应发生率分别为2.78％,5.56％,差异无统计学意义(P>0.05).结论 雷公藤多苷能有效改善慢性肾炎患者肾功能,降低炎症水平,减少尿蛋白.

目的 探讨血清铁蛋白(SF)、单核细胞趋化蛋白-1(MCP-1)水平与糖尿病肾病透析患者感染的相关性.方法 选取2016年3月至2019年3月在合肥市滨湖医院治疗的糖尿病肾病血液透析患者118例,根据有无感染分为感染组和非感染组,每组59人;同时选取糖尿病肾病非血液透析患者60例作为对照组,检测各组人员血清SF和MCP-1的表达水平,Logistic回归分析SF和MCP-1与糖尿病肾病血液透析合并感染的相关性.结果 感染组患者SF、MCP-1水平表达明显高于非感染组和对照组(P＜0.05);感染组糖尿病患者的血肌酐(Scr)、尿素氮(BUN)、糖化血红蛋白(HbA1c)水平表达明显高于非感染组和对照组(P＜0.05).Logistic回归分析显示,SF和MCP-1与糖尿病肾病血液透析感染的发生有关(P＜0.05).结论 SF和MCP-1表达水平与糖尿病肾病透析患者感染的发生、发展密切相关,应及时关注糖尿病肾病血液透析患者SF和MCP-1表达水平,降低感染的发生.

目的 探讨终末期肾脏病(ESRD)患者血清骨硬化蛋白(SOST)水平与血管钙化(VC)的相关性.方法 选择2018年1月至2019年12月合肥市第一人民集团医院收治的66例ESRD患者作为ESRD组,另选择同期66例体检健康者作为对照组;采用酶联免疫吸附试验检测2组受试者血清SOST水平,应用冠状动脉CT影像进行ESRD患者VC评分;对ESRD组和对照组受试者相关临床指标进行比较,并对不同血清SOST水平ESRD患者相关临床指标进行比较;分析ESRD患者血清SOST水平与VC积分和心脏瓣膜钙化率的相关性.结果 ESRD组患者血清SOST、全段甲状旁腺激素(iPTH)、钙(Ca)、磷(P)、Ca×P、心脏瓣膜钙化发生率显著高于对照组(P<0.05),而血清白蛋白(ALB)水平显著低于对照组(P<0.05);对照组与ESRD组受试者血清载脂蛋白α、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、镁(Mg)水平比较差异无统计学意义(P>0.05).66例ESRD患者中,64例(96.97％)患者发生VC,其中43例(67.19％)患者为中、重度钙化.以血清SOST水平中位数(3.00μg·L-1)为界值将ESRD患者分为SOST<3.00μg·L-1组和SOST≥3.00μg·L-1组,2组患者的性别、体质量指数及血清LDL-C、HDL-C、Ca×P、载脂蛋白α水平比较差异无统计学意义(P>0.05),SOST≥3.00μg·L-1组患者的年龄、透析龄、心脏瓣膜钙化率、VC积分及血清ALB、iPTH、Ca、P、Mg水平显著高于SOST<3.00μg·L-1组(P<0.05).Spearman秩相关分析显示,ESRD患者血清SOST水平与VC积分和心脏瓣膜钙化率呈正相关(r=0.291、0.519,P<0.05).结论 ESRD患者血清SOST水平升高,且血清SOST水平与ESRD患者心脏瓣膜钙化发生率及VC积分呈正相关.血清SOST有望成为反映ESRD患者骨转化水平和VC程度的新指标.

目的 观察维持性血液透析(maintenance hemodialysis,MHD)患者的甲状腺功能异常临床特点.方法 选取合肥市第一人民集团医院滨湖医院2016年1月 ～2018年12月收治的128例行MHD的慢性肾脏病(chronic kidney disease,CKD)患者作为观察组,另选取64例同时期未进行透析的CKD患者作为对照组,按照甲状腺功能检测结果,将患者分别纳入甲状腺功能正常组、甲状腺功能异常组,分析甲状腺功能异常组正常甲状腺功能病态综合征(euthyroid sick syndrome,ESS)发生情况,对甲状腺功能正常组、不同类型ESS患者组的病程、透析龄、甲状腺功能、肾功能等各项指标的差异进行比较,观察患者甲状腺功能异常特点及其影响.结果 观察组甲状腺功能异常、低血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)血症、低游离甲状腺素(free thyroxine,FT4)血症和低FT3、FT4血症发生率均高于对照组,差异有统计学意义(P<0.05).低FT3血症组CKD病程、透析龄、FT3、甲状旁腺激素(parathyroid hormone,PTH)、白蛋白(albumin,ALB)、血红蛋白(hemoglobin,Hb)低于甲状腺功能正常组,其FT4高于后者;低FT4血症组FT3、PTH、尿素氮(urea nitrogen,BUN)、血肌酐(serum creatinine,sCr)高于甲状腺功能正常组,其FT3、TSH、ALB、Hb低于后者;低FT3、FT4血症组FT3、FT4、PTH、ALB、Hb均低于甲状腺功能正常组.Pearson相关性分析示,FT3与透析龄、PTH、Hb呈正相关,与ALB呈负相关;FT4与PTH呈负相关(P<0.05).结论 MHD患者甲状腺功能异常较为常见,且以低FT4血症为主,患者甲状腺功能变化与营养状态、贫血有关,建议开展早期干预.

目的:对比用连续性血液净化疗法和间歇性血液净化疗法治疗急性肾功能衰竭的临床效果.方法:将2018年1月至12月期间合肥市滨湖医院收治的60例急性肾功能衰竭患者分为对照组(n=30)和观察组(n=30).对对照组患者采用间歇性血液净化疗法进行治疗,对观察组患者采用连续性血液净化疗法进行治疗.然后,比较两组患者的临床疗效、血肌酐的水平、全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数、纤维蛋白原的水平及红细胞压积.结果:治疗后,与对照组患者相比,观察组患者治疗的总有效率更高,其血肌酐的水平、全血高切黏度、全血低切黏度、血浆黏度、红细胞聚集指数、纤维蛋白原的水平及红细胞压积均更低(P<0.05).结论:与进行间歇性血液透析治疗相比,对急性肾功能衰竭患者进行连续性血液净化治疗的临床效果更好.

目的 观察高流量血液透析在终末期肾病(ESRD)患者中的应用效果.方法 选取2016年10月-2018年10月于我院接受血液透析的ESRD患者,根据透析方式的不同分为高流量血液透析组和常规透析组.观察两组患者透析前后肾功能、免疫功能、代谢水平和炎症因子水平的差异.结果 两组患者治疗前肾功能指标无差异(P>0.05);治疗后,高流量血液透析组患者的BUN、SCr水平低于常规透析组,KT/V水平高于常规透析组(P<0.05);两组患者治疗前免疫指标无差异(P>0.05),治疗后高流量血液透析组患者的CD3+、CD4+水平高于常规透析组,CD8+水平低于常规透析组(P<0.05);两组患者治疗前代谢指标无差异(P>0.05),治疗后,高流量血液透析组患者的血清磷、甲状旁腺激素低于常规透析组(P<0.05);两组患者透析前炎症因子水平无差异(P>0.05),治疗后,高流量血液透析组患者的hs-CRP、TNF-α、IL-6水平低于常规透析组(P<0.05).结论 高流量血液透析在ESRD患者中的应用效果较好,可明显改善患者的肾功能,具有良好的应用价值.

目的 了解维持性血液透析(maintenance hemodialysis,MHD)患者血管钙化情况及相关影响因素分析.方法 记录72例MHD患者人口学特征、临床及实验性检查资料,根据腹主动脉钙化评分(abdominal aortic calcification score,AACs)分为无钙化/轻度钙化组和中重度钙化组.检测血钙、血磷、碱性磷酸酶(alkaline phosphatase,ALP)、C反应蛋白(C reactive protein,CRP)、全段甲状旁腺激素(intact parathyroid hormone,iPTH)、血清骨硬化蛋白、白介素(interleukins,IL)-37水平.结果72例患者中有无钙化19例、轻度钙化11例、中度29例、重度13例.中重度钙化组年龄、透析龄、血钙、血磷、ALP、CRP及iPTH水平高于无钙化/轻度钙化组,差异均具有统计学意义(均有P ＜0.05).中重度钙化组血清骨硬化蛋白、IL-37水平高于无钙化/轻度钙化组,差异均有统计学意义(均有P＜0.05).Logistic回归分析结果显示高龄、高血钙、iPTH水平增加是MHD患者腹主动脉中重度钙化的独立危险因素(均有P＜0.05).结论 MHD患者普遍存在血管钙化,对血管钙化相关影响因素分析研究可能为血管钙化防控提供新靶点.

Objective To analyze the abnormal factors of the disorder status of calcium-phosphorus metablism in maintenance hemodialysis patients.Methods Serum calciun,serum phosphorus,calcium-phosphorus product and iPTH were detected in 130 patients with maintenance hemodialysis,and compared with the indicators of K/DOQI2003 and KDIGO2009 guidelines.Results Eligibility rate about serum calcium and phosphorus and multiplication and the level of intact parathyroid hormone were 48.12%,48.23%,78.75%,20.28% respectively by the indicators of K/DOQI2003 guidelines.There were 47.71%,28.74%,38.30% respectively by the indicators of KDIGO2009 guidelines.The level of serum phosphorus was lower in patients whose blood flow over 300mL/min than patients whose blood flow less than 300mL/min(t=2.892,P<0.05).The level of serum calciun,calcium-phosphoris product and PTH were higher in patients whose hemodialysis vintage over 3 years than patients whose hemodialysis vintage lower 3 years(t=2.479,5,681,3.012,P<0.05).The level of serum phosphorus and calcium-phosphoris product were lower in patients whose age over 50 years than patients whose age lower 50 years(t=2.212,3.367,P<0.05).Conclusion There is abnormal calcium and phosphorus metabolism in the patients with maintenance hemodialysis,which don′t reach the K/DOQI and KDIGO guidelines.As the dialysis time increase,the abnormal mineral metabolism become more obviously.

Objective To understand the quality of life（QOL）and its influencing factors in maintenance hemodialysis patients（hemodialysis maintenance,MHD）,and to provide theoretical basis for improving QOL of patients.Methods A cross-sectional study was conducted in the blood purification centre in 8 hospitals in Hefei,and patients’clinical data were collected.KDQOL-SF self-ad-

目的：：结合生物电阻抗( bioimpedence analysis,BIA)及颈动脉超声对透析病人营养不良状态与动脉硬化相关性进行早期评估。方法：随机选择我院维持性血液透析病人(maintenance hemodialysis,MHD)46例,透析时间均大于3个月,根据颈动脉彩超有无颈动脉粥样斑块形成分为两组,颈动脉斑块形成31例,无颈动脉粥样斑块形成15例,分别测定两组患者的超敏C反应蛋白( hs-CRP)、血清前白蛋白( PA)、白蛋白( Alb)、血红蛋白( Hb)、颈动脉中层厚度( IMT)。生物电阻抗测定体质指数( BMI)、去脂体重( FFM)、体脂百分比( Fat%)、体脂肪量。结果：两组患者的体脂百分比差异存在统计学意义(P<0.01),两组患者的体重指数、去脂体重、白蛋白、前白蛋白、H-CRP、Hb、iPTH、收缩压及透析龄亦差异存在统计学意义(P<0.05)。结论：BIA可以反应病人营养状况,尤其是肌肉含量减少,脂类含量异常,与hs-CRP升高及动脉硬化正相关性,与血清白蛋白、血红蛋白呈负相关,可较好预测营养状态及动脉硬化风险。

Objective To evaluate the fluid distribution in patients on maintenance hemodialysis(MHD)by the whole-body bioimpedanc spectroscopy and investigate its effect on blood pressure in MHD patients. Methods A total of 64 patients with stable MHD for more than 3 months were enrolled in this study. Based on inter-dialysis blood pressure control,they were divided into ideal blood pressure group(41 cases)and refractory hypertension group(23 cases). Preand post-dialysis intracellular water(ICW)and extracellular water(ECW)were measured by whole-body multifrequency bioimpedance spectroscopy,and standardized by body weight to produce ICW% and ECW% . 64 normal individuals of matched sex,age and body weight were used as controls. Results The pre-HD ECW% was significantly higher than those of normal controls(P < 0. 01). Patients with MHD had higher pre- and post-dialysis ECW% values than those without hypertension. Conclusion MHD patients have higher pre-dialysis ECW% . MHD patients with hypertension are significantly higher than the ideal blood pressure control group.

目的 探讨高通量血液透析(high permeable hemodialysis,HPD)对维持性血液透析(maintenance hemodialysis,MHD)患者颈动脉粥样硬化的影响及机制.方法 维持性血液透析的患者60例,高通量透析组(HPD组)和普通透析组(LPD组)各30例.HPD组采用费森尤斯公司FX60高通量透析器,LPD组采用费森尤斯公司F7透析器.两组患者每周透析时间均为12 h.治疗时间6个月,观察两组患者治疗前后血压、血脂、甲状旁腺激素(parathyroid hormone,PTH)及钙磷乘积、颈总动脉内膜-中层厚度(intima medial thickness,IMT).结果 治疗6个月后,LPD组收缩压、平均动脉压、三酰甘油、钙磷乘积和PTH指标与透析前相比差异无统计学意义(P>0.05).与LPD组相比,HPD组收缩压和平均动脉压明显降低,三酰甘油水平和IMT值低于LPD组(P<0.05),颈总动脉IMT低于LDP组(P<0.05),但两组患者钙磷乘积和PTH差异无统计学意义(P>0.05).结论 高通量透析模式可以延缓维持性血液透析患者颈动脉粥样硬化进展,其对血压和血脂的影响可能是其中机制.

Aim To observe the effect of high permeable hemodialysis(HPD) using different membrane on hypertension and parathyroid hormone in patients with maintenance hemodialysis.Methods 52 patients with maintenance hemodialysis were randomly divided into two groups.26 cases were treated with HPD using F60 dialyser(HPD group),and 26 cases were treated with low permeable hemodialysis(LPD)using F7 dialyser(LPD group).Results At the beginning of hemodialysis,there were no significant differences in blood pressure,heart rate,calcium-phosphorus product and PTH between the 2 groups(P0.05).After the dialysis for six months,In LPD group,blood pressure,heart rate,calcium-phosphorus product and PTH remained unchanged.Systolic pressure and mean arterial pressure levels were significantly lower in HPD group compared with those in LPD group(P0.05),but the changes of calcium-phosphorus product and PTH levels did not reach statistical significance(P0.05).Conclusion HPD is effective in improving hypertension in hemodialysis patients,but the changes of calcium-phosphorus product and PTH levels don't reach statistical significance.

Objective To investigate the serum level of TGF-β, Th1 cytokine IFN-y and Th2 cytokine IL-10 in patients with systemic lupus erythematosus (SLE) and to explore their role in the pathogenesis of SLE. Methods 54 patients with SEE were divided into ones with active SEE and ones with inactive SLE according to their SLEDAI score. ELISA was employed for the levels of TGF-β, IFN-γ and IL-10 in serum of 54 patients with SEE and 20 health volunteers. Results The level of serum TGF-β in patients with SEE was significantly lower than that normal controls (P＜0.01). The levels of serum IFN-γ and IL-10 were significantly increased compared with those in normal controls (P＜0.01). serum TGF-β level was positively correlated with Hb, PLT numbers and RBC numbers. IFN-γ was negtively correlated with complement C3 and C4 and positively correlated with anti-C1q, anti-nucleosome and immunoglobulin (IgG). IL-10 was positively correlated’ with anti-nucleosome and immunoglobulin (IgG). Conclusion Both Th1 and Th2 might participate in the pathogenesis of SLE. The combined detection of serum TGF-β、IFN-γ and IL-l0of patients with SEE may have some practical significance for the guidance of clinical treatment and the evaluation of the disease activity.

Objective To investigate the serum level of TGF-β,Th1 cytokine IFN-γ and Th2 cytokine IL-10 in patients with systemic lupus erythematosus(SLE) and to explore their role in the pathogenesis of SLE.Methods 54 patients with SLE were divided into ones with active SLE and ones with inactive SLE according to their SLEDAI score.ELISA was employed for the levels of TGF-β,IFN-γ and IL-10 in serum of 54 patients with SLE and 20 health volunteers.Results The level of serum TGF-β in patients with SLE was significantly lower than that normal controls(P<0.01).The levels of serum IFN-γ and IL-10 were significantly increased compared with those in normal controls(P<0.01).serum TGF-β level was positively correlated with Hb,PLT numbers and RBC numbers.IFN-γ was negtively correlated with complement C3 and C4 and positively correlated with anti-C1q,anti-nucleosome and immunoglobulin(IgG).IL-10 was positively correlated with anti-nucleosome and immunoglobulin(IgG).Conclusion Both Th1 and Th2 might participate in the pathogenesis of SLE.The combined detection of serum TGF-β、IFN-γ and IL-10of patients with SLE may have some practical significance for the guidance of clinical treatment and the evaluation of the disease activity.

Aim To observe the effect of ascorbic acid(AA) in improving anemia and nutritional status of maintenance hemodialysis(MHD) patients.Method Data of 60 dialysis patients from March 2007 to June 2007 treated in our blood purification center were analyzed.There are 22 females and 38 males,with an average age of(58±13) years,average dialysis time(23±9) months,stable dialysis time all more than 6 months and KT/V1.2.Patients are randomly divided,30 patients in treatment group and 30 in controlled group.Patients in treatment group were treated with AA for 3 months.Before and after the treatment,all in both groups had routine examination on hemoglobin,albumin,serum creatinine,hs-CRP,and all checked malondiadehyde and AA content with spectrophotometry,serum TNF-α,IL-1β level with RIA.Results Before AA treatment,there was no statistical significance in the age,dialysis,primary disease,hemoglobin,albumin,serum creatinine of MHD patients in both treatment group and non-treatment group.After treated with AA for 3 months and in comparison with the non-treatment group,the hemoglobin of patients in treatment group was obviously higher(P0.05),the TNF-α,IL-1β,CRP,MDA level significantly lower(P0.05),and TAA in plasma obviously increased(P0.05).Conclusion AA is clearly effective in improving anemia of patients,which is in relation with AA's restraining on TNF-α and IL-1β levels of patients.

Aim To probe the influence of variablesodium dialysis on the changes in blood pressure of patients with maintenance hemodialysis.Methods The patients in our hospital were diviged into groups in terms of their blood pressure.Hypertensive patients are in group-A,optimal blood pressures patients are in group-B.The therapeutic schemes on the patients of the two groups were both based on the original therapy,they would receive variablesodium dialysis(VSD)for 3 months after their receiving standardsodium dialysis(SSD)for 3 months,for the purpose of investigating the influence of serum sodium concentration and blood pressure with different therapeutic schemes on patients in the two groups.Results Blood pressure was changed after different therapeutic schemes.The blood pressure of patients with hypertension(Group A)was obviously improved 3 months after VSD treatment,while that of patients with optimal blood pressures(Group B)was recognizably increased 3 months after SSD treatment.There was statistical significance in the data on the two groups,(P0.05),however after patients with hypertension(Group A)was received SSD for 3 months,there was no statistical significance in the changes of blood pressure.The two therapeutic schemes had no notable effect on the sodium serum concentration.Conclusions Variablesodium dialysis(VSD)had a favorable effect on the blood pressure of patients with maintenance hemodialysis and no notable changes on the concentration of their serum sodium concentration,however when it came to the patients in different subgroups,there was a different effect on their blood pressure.

Objective To monitor the real-time blood volume of the patients with maintenance hemodialysis via online blood volume monitoring and variablesodium dialysis(VSD),and work out individualized dialysis plan.Methods 40 patients with treatment of maintenance standardsodium dialysis(SSD)were divided into groups in terms of the fact whether they occurred iteratively the hypotensive reaction or not during treatment.Simultaneously the blood volume of patients in each group was real-time monitored.Based on real-time monitoring patients of the above two group,to observing the record threshold of average △BV in the process of ultrafiltration by applying VSD,meanwhile,observing the △BV between the two treetment.Results The patients who were prone to iteratively occur the hypotension in the process of ultrafiltration showed the statistical differences(P>0.05)in many aspect,such as age,the age of dialysis,single total ultrafiltration,plasma albumin,hemoglobin,etc.Such uncomfortable reaction as hypotension was reduced after VSD base on this,as well as there was statistical significance.There was a different threshold of volume with statistical significance compared to SSD.After 3 month VSD treatment,we also found that the blood pressure of patients with hypertension was obviously improved compared with patients without treatment.Conclusion Our study shows that the factors that can put impact on the threshold change of blood volume of patients with hemodialysis are primary disease,age,age of dialysis,increasing degree of weight in the process of dialysis and the nutrition status.VSD can improve the hypotensive reaction;and the threshold of blood volume has a remarkable change.VSD has a favorable control on the blood pressure of patients with hypertension compared to SSD.