联用参麦注射液与左卡尼汀治疗血液透析期间低血压的效果及对血流动力学的影响

Effect of Shenmai Injection Combined with Levocarnitine in the Treatment of Hypotension During Hemodialysis and its Influence on Hemodynamics

目的研究联用参麦注射液与左卡尼汀治疗血液透析期间低血压的效果及对血流动力学的影响。方法以2020年7月-2022年7月于江西医学高等专科学校第一附属医院行血液透析治疗的80例血液透析相关性低血压(IDH)患者为研究对象,按照随机数字表法分为对照组(40例)与观察组(40例),对照组给予左卡尼汀治疗,观察组在其基础上联用参麦注射液治疗。比较两组临床疗效、血压水平[收缩压(SBP)、舒张压(DBP)]、血流动力学指标[平均动脉压(MAP)、心率(HR)]、血透相关指标[尿素清除指数(KT/V)、超滤量]。结果观察组总有效率高于对照组(P<0.05);两组透析中SBP、DBP水平均低于透析前,两组透析后SBP、DBP水平均高于透析中(P<0.05),且观察组透析中及透析后SBP、DBP水平均高于对照组(P<0.05)。对照组透析后MAP低于透析前,HR高于透析前(P<0.05),观察组透析前后MAP、HR比较,差异无统计学意义(P>0.05),且两组透析后MAP、HR比较,差异有统计学意义(P<0.05)。观察组KT/V值、超滤量均大于对照组(P<0.05)。结论参麦注射液联合左卡尼汀治疗血透期间低血压疗效突出,可减少血压波动,改善患者血流动力稳定性,提高透析充分性,值得临床应用。

Objective To study the effect of Shenmai injection combined with levocarnitine in the treatment of hypotension during hemodialysis and its influence on hemodynamics.Methods A total of 80 patients with intradialytic-hypotension(IDH)who underwent hemodialysis in the First Affiliated Hospital of Jiangxi Medical College from July 2020 to July 2022 were selected as the research objects.According to the random number table method,they were divided into control group(40 patients)and observation group(40 patients).The control group was treated with levocarnitine,and the observation group was treated with Shenmai injection on the basis of levocarnitine treatment.The clinical efficacy,blood pressure level[systolic blood pressure(SBP),diastolic blood pressure(DBP)],hemodynamic indexes[mean arterial pressure(MAP),heart rate(HR)],hemodialysis related indexes[urea clearance index(KT/V),ultrafiltration volume]were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The levels of SBP and DBP during dialysis in the two groups were lower than those before dialysis,and the levels of SBP and DBP after dialysis in the two groups were higher than those during dialysis(P<0.05),and the levels of SBP and DBP during and after dialysis in the observation group were higher than those in the control group(P<0.05).After dialysis,MAP in the control group was lower than that before dialysis,and HR was higher than that before dialysis(P<0.05).There was no significant difference in MAP and HR before and after dialysis in the observation group(P>0.05),and there were significant differences in MAP and HR between the two groups after dialysis(P<0.05).The KT/V value and ultrafiltration volume of the observation group were higher than those of the control group(P<0.05).Conclusion Shenmai injection combined with levocarnitine is effective in the treatment of hypotension during hemodialysis,which can reduce blood pressure fluctuation,improve hemodynamic stability and dialysis adequacy,it is worthy of clinical application.