中国血液净化

›› 2005, Vol. 4 ›› Issue (12): 657-659.

• 论著 • 上一篇    下一篇

米多君预防反复发生的血液透析相关性低血压疗效观察

许元文 梁艳冰 张涤华 潘健涛 吴培根 沈清瑞 余学清

  

  1. 510080 广州，中山大学附属第一医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-12-12 发布日期:2005-12-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-12-12 Published:2005-12-12

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摘要： 目的 观察米多君预防反复发生的血液透析相关性低血压(IDH)的效果。方法 广州中山大学附属第一医院肾内科反复发生IDH的血液透析患者27例，口服米多君2.5～5.0mg/次，每天3次，血液透析前或既往IDH出现前30min再服米多君5mg，透析处方不变，观察透析中血压变化和IDH发生情况。结果 27例血液透析患者米多君治疗前后血液透析中脱水速度、透析液钠浓度和温度、透析前血压比较差异没有显著性 (P＞0.05)；米多君治疗后总脱水量、Kt/V、透析结束血压均高于治疗前 (P＜0.05)，透析过程最低血压与透析前血压的差值低于治疗前 (P＜0.01)，IDH发生例次、症状性IDH发生例次均低于治疗前(P＜0.01)，其中显效11例（40.73%)，有效9例（33.3%），无效7例（占26.0%）。结论 米多君可有效预防IDH的发生。

关键词: 慢性肾衰竭, 盐酸米多君, 血液透析, 低血压

Abstract: Objective To study the effect of midodrine to prevent the hemodialysis-related hypotension (IDH) in maintained-hemodialysis (MHD) patients. Methods 27 MHD patients who had usually showed IDH were involved. These patients received hemodialysis with the same hemodialysis prescription, but took orally Midodrine 7.5～15mg for three times every day, and took orally another 5mg at 30 minutes before hemodialysis or onset of IDH. Blood pressure and IDH were observed during hemodialysis. Results Ultrafiltration rate, pre-hemodialysis blood pressure, temperature and sodium concentration of dialysate were no significant difference between before and after Midodrine treatment in 27 cases (P＞0.05). After Midodrine treatment, total ultrafiltrated volumes, the lowest intrahemodialysis blood pressure, and post-hemodialysis blood pressure were increased significantly (P＜0.05), and the cases showed IDH, symptomatic IDH were reduced(P ＜0.01). Midodrine treatment showed significant effect in 11 cases (40.7% ), showed effect in 9 (33.3%), and showed no effect in 7 (26.0%). Conclusion We suggest that Midodrine treatment can effectively prevent hemodialysis-related hypotension in MHD patients.

Key words: Midodrine, Hemodialysis, Hypotension

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