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药物应用与老年患者水合状态的关系。

Association of Drug Application and Hydration Status in Elderly Patients.

机构信息

Institute for Bioanalysis, Coburg University of Applied Sciences and Arts, Friedrich-Streib-Str. 2, D-96450 Coburg, Germany.

Division of Geriatrics, Klinikum Coburg GmbH, Ketschendorfer Str. 33, D-96450 Coburg, Germany.

出版信息

Nutrients. 2021 Jun 4;13(6):1929. doi: 10.3390/nu13061929.

Abstract

Due to multifactorial reasons, such as decreased thirst and decreased total body water, elderly patients are vulnerable to dehydration. Mild cognitive impairment (MCI) or dementia increase the risk of dehydration and, in turn, dehydration decreases cognitive performance. The study aims to identify and assess differences in hydration status, taking into account patients' drug treatment and diseases, using bioelectrical impedance vector analysis (BIVA), thereby revealing unfavorable aspects of prognosis. 447 geriatric patients (241 women, 206 men) including information on medication and bioelectrical impedance analysis (BIA) were investigated, which allowed studying the association between 40 drugs and the hydration status. First, patients were divided into disease groups. Renal disease and diuretic treatment were significantly different in both sexes, whereas cardiovascular patients differed exclusively for females. Next, drug enrichment was examined in either hyperhydrated or dehydrated patients. Simvastatin, candesartan, bisoprolol, amlodipine, olmesartan, furosemide, torasemide, allopurinol, mirtazapine, pantoprazole, cholecalciferol, and resveratrol showed enrichment depending on hydration status. This study demonstrated that patients can be differentiated and stratified by BIVA, taking into account medication and disease associated with hydration status. Although patients diagnosed with MCI and therefore treated with resveratrol, BIVA still showed evaluated dehydration. This is unfavorable in terms of prognosis and requires special attention.

摘要

由于多种因素,如口渴减少和总体水量减少,老年患者易脱水。轻度认知障碍(MCI)或痴呆症会增加脱水的风险,而脱水反过来又会降低认知表现。本研究旨在使用生物电阻抗向量分析(BIVA)识别和评估水合状态的差异,同时考虑患者的药物治疗和疾病,从而揭示预后的不利方面。对 447 名老年患者(241 名女性,206 名男性)进行了药物治疗和生物电阻抗分析(BIA)信息调查,以研究 40 种药物与水合状态之间的关联。首先,患者被分为疾病组。在两性中,肾病和利尿剂治疗有显著差异,而心血管疾病仅在女性中存在差异。接下来,在高水合或脱水患者中检查药物富集。辛伐他汀、坎地沙坦、比索洛尔、氨氯地平、奥美沙坦、呋塞米、托拉塞米、别嘌醇、米氮平、泮托拉唑、胆钙化醇和白藜芦醇的富集取决于水合状态。这项研究表明,BIVA 可以考虑与水合状态相关的药物和疾病,对患者进行区分和分层。尽管患有 MCI 并因此接受白藜芦醇治疗的患者,BIVA 仍然显示出评估的脱水。这在预后方面是不利的,需要特别关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f824/8226953/c8c9daa30531/nutrients-13-01929-g001.jpg

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