血液透析滤过联合盐酸米多君治疗透析低血压的临床研究  

Impact of hemodiafiltration combined with midodrine hydrochloride in the treatment of intradialytic hypotension

作　　者：崔龙[1] 胡凤琪[1] 秦永芳[1] 袁海[1] 

机构地区：[1]襄阳市中心医院肾内科,湖北襄阳441021

出　　处：《海南医学》2013年第20期2986-2988,共3页Hainan Medical Journal

基　　金：湖北省卫生厅青年科技人才立项资助(编号:X2012-41)

摘　　要：目的探讨血液透析滤过(HDF)联合盐酸米多君治疗透析性低血压的疗效及其可能机制。方法选取20例透析低血压患者,HD与HDF各进行10次,每组均加用盐酸米多君。监测透析过程中平均动脉压(MAP)、心率(HR)、每搏输出量(SV)、及发生低血压的例次,并检测每种透析治疗模式后血红蛋白(Hb)、总蛋白(TP)、白蛋白(Alb)、谷丙转氨酶(ALT)水平。结果 HDF+盐酸米多君组治疗后MAP、SV均较同时间点HD+盐酸米多君组显著增加(P<0.05),低血压发生例次显著降低(P<0.05),患者低血压症状评分较前降低。两种模式在治疗前及治疗后HR、Hb、TP、Alb、ALT差异无统计学意义(P>0.05)。结论 HDF联合盐酸米多君较单纯HD加盐酸米多君治疗对透析性低血压的防治具有更好的疗效。Objective To investigate the effects of the combinative therapy ofmidodrine hydrochloride and hemodiafiltration （HDF） on intradialytie hypotension and its mechanism. Methods Twenty patients with intradialyt- ie hypotension underwent midodrine hydrochloride ＋ HDF and hemodialysis （HI）） ＋ midodrine hydrochloride for 10 times, respectively. Mean arterial blood pressure （MAP）, heart rate （FIR）, and strokevolume （SV） were measured dur- ing dialysis session. The frequency of hypotension was also recorded. The levels of hemoglobin （Hb）, total protein （TP）, albumin （Alb）, alanine aminotransferase （ALT） were detected. Results Compared with HD＋ midodrine hydro- chloride, the frequency of hypotension and the scores of hypotension symptom in HDF ＋ midodrine hydrochloride group was significantly reduced （P〈0.05）, and MAP and SV were significantly improved （P〈0.05）. The levels of HR, Hb, TP, Alb, and ALT for the two therapies showed no statistically significant difference before and after treatment. Conclusion The eombinative therapy of midodrine hydrochloride and HDF has significantly therapeutic effects on intradialytic hypotensin.

关 键 词：血液透析滤过 血液透析 透析低血压 盐酸米多君 

分 类 号：R459.5[医药卫生—治疗学]