黄芪注射液联合50%葡萄糖注射液治疗尿毒症合并慢性心功能不全患者透析相关性低血压临床观察

目的探讨黄芪注射液联合50%葡萄糖注射液治疗尿毒症合并慢性心功能不全患者透析相关性低血压的临床疗效。方法选择2009年1月—2010年12月在我院透析过程中反复发生低血压的尿毒症合并慢性心功能不全的患者40例,将其随机分成2组,每组20例,对照组常规血液透析过程中加50%葡萄糖注射液持续静脉滴注,观察组在对照组基础上加用黄芪注射液,治疗8周,观察两组血压变化情况及治疗效果。结果治疗过程中低血压发生率观察组低于对照组（P〈0.05）;治疗后观察组收缩压、平均动脉压均高于对照组（P〈0.05,P〈0.01）;两组治疗后左心室射血分数（LVEF）均高于治疗前,且治疗后LVEF观察组高于对照组（P〈0.05）;治疗总有效率观察组高于对照组（P〈0.05）。结论黄芪注射液联合50%葡萄糖注射液可降低尿毒症合并慢性心功能不全患者透析相关性低血压发生率,明显地增加了LVEF,提高了对透析的耐受性。

Astragalus Combined with 50%Glucose in Treatment of Patients with Uremia Combined with Chronic Cardiac Insufficiency Hypotension Correlation by Dialysis

Objective To explore the clinical effect of astragalus injection combined with 50% glucose in treatment of patients with uremia combined with chronic cardiac insufficiency hypotension correlation by dialysis.Methods 40 patients with uremia combined with chronic cardiac insufficiency who had repeatedly dialysis related hypotension in hemodialysis during January 2009 and December 2010 were randomly divided into therapy group（n=20） and control group（n=20）.Patients in control group were treated with 50% glucose injection,while therapy group were treated with 20ml astragalus combined with 50% glucose by continuous intravenous infusion.The changes of blood pressure and treatment effectiveness of the two groups were compared.Results The incidence of hypotension therapy group was lower than that of control group during course of treatment（P0.05）;systolic blood pressure and mean arterial blood pressure of therapy group were higher than those of control group after treatment（P0.05,P0.01）;LVEF was higher after treatment than that before treatment in two groups,and LVEF increment in therapy group after treatment was higher than that of control group（P0.05）;the total effective rate of treatment in therapy group was higher than that of control group（P0.05）.Conclusion Astragalus injection combined with 50% glucose in treatment of patients with uremia combined with chronic cardiac insufficiency hypotension correlation by dialysis can reduce incidence rate,significantly improve LVEF and raise dialyzed tolerance.