盐酸米多君防治老年糖尿病肾病患者发生透析中低血压的疗效观察

Effect of midodrine hydrochloride on prevention and treatment of intradialytichypotension among elderly patients with diabetic nephropathy

目的:探讨盐酸米多君不同收缩压时给药对防治老年糖尿病肾病维持性血透(maintenancehemodialysis,MHD)患者发生透析中低血压(intradialytic-hypotension,IDH)的疗效。方法:将36例反复发生透析中低血压的老年糖尿病肾病维持性血透患者随即分为3组:A、B、C组,每组12例。3组患者均在血透前30min服用盐酸米多君5mg,血透开始时收缩压均高于130mmHg。A组患者在透析中监测收缩压降至110 mmHg时,即补服盐酸米多君5 mg;B组患者在透析中收缩压降至120 mmHg时,即补服盐酸米多君5mg;C组患者在透析中收缩压降至130mmHg时,即补服盐酸米多君5mg。结果:B组总有效率与A组无明显差异(P>0.05),C组总有效率明显高于A、B组(P<0.05)。结论:盐酸米多君在收缩压降至130mmHg时给药更有效的降低老年糖尿病肾病维持性血透患者发生透析中低血压的风险。

Objective： To investigate the effect of midodrine hydrochloride administered at different systolic blood pressure on intradialytic-hypotension （IDH） of elderly maintenance hemodialysis （MHD） patients with diabetic nephropathy. Methods： 36 elderly MHD patients with diabetic nephropathy were randomly divided into three groups, 12 patients each. All the patients took midodrine hydrochloride 5mg 30 minutes before hemodialysis, and their systolic blood pressure was higher than 130 mmHg at the beginning of dialysis.Patients in group A, B, and C took midodrine hydrochloride 5 mg when systolic blood pressure dropped to 110,120, and 130 mmHg respectively. Results： There was no significant difference in the total effective rate between group A and group B （P 〉 0.05）. However the total effective rate in group C was significantly higher than that in group A and B （P 〈 0.05）. Conclusion： Midodrine hydrochloride administered while systolic blood pressure dropped to 130 mong elderly MHD patients with diabetic nephropathy. mmHg can effectively reduce the risk of IHD a-