中文摘要：

背景在 hemodialysis (HD ) 期间支撑了低血压是一个重要临床的问题。血浆 adrenomedullin (AM ) 与持续低血压在 HD 病人被增加，但是很少搬迁 AM 是否能改进低血压被知道。这研究的目的是调查在增加的血浆 AM 层次的移动上使用高流动的 dialyzer 并且与经历维护 HD 超过一年了的 48 个老病人(年龄 65 以上)是的持续 hypotension.Methods 在老 HD 病人改进低血压的 hemodialysis 的有益的效果招募并且学习。我们在持续低血压评估了 AM 的血浆层次(嘘；n=28 ) 并且正常血压(NT；n=20 ) 病人。有低血压的病人进一步被划分成二亚群并且与 eitherhigh 流动对待 dialyzer 或低流动的 dialyzer 3 个月。血浆 adrenomedullin 层次和血压在 AM 的 0 和 181 个 .Results 血浆层次是的天被分析在显著地更高嘘与比在 NT 病人((24.92 汵牡映捡潴獲栠癡?? 潲敬椠 ? 桴 ? 慰桴杯湥獥獩漠 ??.? 觌 ? 觌吗？？

英文摘要：

Background Sustained hypotension during hemodialysis （HD） is an important clinical issue. Plasma adrenomedullin （AM） is increased in HD patients with sustained hypotension, but little is known about whether removing AM can improve hypotension. The objective of this study was to investigate the beneficial effects of hemodialysis using a high-flux dialyzer on removal of increased plasma AM levels and improving low blood pressure in elderly HD patients with sustained hypotension.Methods Forty-eight elderly patients （age 65 or older） who had undergone maintenance HD for more than one year were recruited and studied. We evaluated plasma levels of AM in sustained hypotension （SH; n=28） and normotensive （NT; n=20） patients. The patients with hypotension were further divided into two subgroups and treated with eitherhigh-flux dialyzer or low-flux dialyzer for 3 months. Plasma adrenomedullin levels and blood pressure were analyzed at days 0 and 181.Results Plasma levels of AM were significantly higher in SH than in NT patients （（24.92±3.7） ng/L vs. （15.52±6.01） ng/L,P〈0.05）, and were inversely correlated with mean arterial blood pressure （MAP） at pre-HD. After 3 months, the level of plasma AM in high-flux group was decreased （（24.58±4.36） ng/L vs. （16.18±5.08） ng/L, P 〈0.05）, but MAP was increased （（67.37±4.31） mmHg vs. （74.79±3.59） mmHg, P〈0.05）. There was no obvious change in low-flux group.Conclusions Plasma AM levels were significantly elevated in elderly HD patients with SH. High-flux dialyzer therapy can decrease plasma AM level and improve hypotension.