CAJ | 학술논문

目的：对单硝酸异山梨醇酯缓释片导致老年低血压进行分析，以便更好的进行防治。方法对8例因鼻饲单硝酸异山梨醇酯缓释片后，导致低血压状态的老年患者的临床特点、救治情况进行分析，并与同期相同方式用药未出现低血压的9例患者进行对比分析。结果8例患者均为60 mg/日，用药后出现低血压，6例患者使用多巴胺升压、扩容等综合治疗后好转，严重1例并发急性心肌梗死及急性肾功能衰竭，经机械通气等抢救好转。与非低血压组比较，病情不稳定、单硝酸异山梨醇酯用药剂量大、时间长、并用降压药物、近期鼻饲给药比例较高，差异有统计学意义（P＜0.05）。结论高龄老年患者尤其是病情不稳定、并用降压药物、近期鼻饲使用高剂量单硝酸异山梨醇酯缓释片容易出现低血压，甚至可导致严重并发症。
목적：대단초산이산리순지완석편도치노년저혈압진행분석，이편경호적진행방치。방법대8례인비사단초산이산리순지완석편후，도치저혈압상태적노년환자적림상특점、구치정황진행분석，병여동기상동방식용약미출현저혈압적9례환자진행대비분석。결과8례환자균위60 mg/일，용약후출현저혈압，6례환자사용다파알승압、확용등종합치료후호전，엄중1례병발급성심기경사급급성신공능쇠갈，경궤계통기등창구호전。여비저혈압조비교，병정불은정、단초산이산리순지용약제량대、시간장、병용강압약물、근기비사급약비례교고，차이유통계학의의（P＜0.05）。결론고령노년환자우기시병정불은정、병용강압약물、근기비사사용고제량단초산이산리순지완석편용역출현저혈압，심지가도치엄중병발증。
Objective To analyze the occurrence of senile hypotension induced by isosorbide-5-mononitrate in order to prevent and cure well hypotension. Methods The clinical characteristics and remedy were analyzed in 8 elderly patients with hypotension after nasal feeding of isosorbide-5-mononitrate, who were compared with other 9 patients without hypotension after nasal feeding of isosorbide-5-mononitrate at the same time. Results The patients (n=8) suffered from hypotension after nasal feeding of isosorbide-5-mononitrate (60 mg/d), among them, 6 were relieved after blood pressure-elevating and volume-expansion treatment with dopamine, 1 had acute myocardial infarction and acute renal failure and relieved after rescue of mechanical ventilation. The clinical characteristics included unstable condition, higher dose and longer time of taking isosorbide-5-mononitrate, administration of anti-hypertension drugs, and higher proportion of recent nasal feeding in hypotension group, and the difference was statistical significant between hypotension group and non-hypotension group (P<0.05). Conclusion In elderly patients, especially for those with unstable condition, taking anti-hypertension drugs, and taking higher dose of isosorbide-5-mononitrate at recent time, hypotension will be induced and even more severe complications may occurred.