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目的:探讨肾康注射液维持治疗对尿毒症血液透析患者残余肾功能的保护作用及其作用机制。方法:将进行血液透析的86例尿毒症患者随机按数字表法分为对照组和观察组各43例。对照组积极处理原发病,给予血液透析治疗,并以营养支持、纠正贫血和控制血糖、血压等常规治疗。观察组在对照组治疗的基础上加用肾康注射液80 m L,静脉滴注,1次/d。连续4周为1个疗程,停药4周后,再进行下1个疗程,共计6个疗程。观察治疗前、治疗后6个月和12个月残余肾功能(RRF)和尿量;计算RRF和尿量下降速度;计算一级终点事件(24 h尿量≤400 m L)的发生率;观察治疗前后血压(BP),体重(BW),血尿素氮(BUN),肌酐(Cre),血红蛋白(Hb),白蛋白(Alb),前白蛋白(PA)变化情况。结果:观察组在治疗后6,12个月RRF和尿量均高于对照组(P<0.01);在平均12个月的观察期间,观察组RRF与尿量下降速率低于对照组(P<0.01);观察组收缩压和舒张压的水平均低于对照组(P<0.01);观察组一级终点事件的发生率为20.9%,低于对照组的44.18%(P<0.05);治疗后两组Hb较治疗前升高,观察组升高更明显(P<0.01);治疗后观察组Alb和PA水平高于对照组(P<0.01);治疗后两组BUN和Scr均比治疗前下降,治疗后观察组Scr水平低于对照组(P<0.01)。结论:肾康注射液维持治疗对尿毒症血液透析患者残余肾功能具有一定的保护作用,能延缓其恶化速度,值得进一步的研究。
Objective: To investigate the protective effect and mechanism of Shenkang injection maintenance therapy on residual renal function in uremic hemodialysis patients. Methods: Eighty-six patients with uremia undergoing hemodialysis were randomly divided into control group and observation group with 43 cases in each group according to the digital table method. The control group actively deal with the primary disease, given hemodialysis treatment, and nutritional support, to correct anemia and control blood sugar, blood pressure and other conventional treatment. Observation group in the control group on the basis of treatment plus Shenkang injection 80 m L, intravenous infusion, 1 / d. 4 weeks for a course of treatment, withdrawal 4 weeks, and then under a course of treatment, a total of 6 courses. Residual renal function (RRF) and urine output were measured before treatment, 6 months and 12 months after treatment. The RRF and the rate of decline of urine output were calculated. The incidence of primary endpoint (24 hour urine output ≤400 m L) The changes of blood pressure (BP), body weight (BW), blood urea nitrogen (BUN), creatinine (Cre), hemoglobin (Hb), albumin (Alb) and prealbumin (PA) were observed before and after treatment. Results: The RRF and urine volume in observation group were higher than those in control group (P <0.01) at 6 and 12 months after treatment. During the 12-month observation period, RRF and urine output in observation group were lower than those in control group (P <0.01). The systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group (P <0.01). The incidence of primary end point in the observation group was 20.9%, which was lower than that in the control group (44.18%, P <0.05). After treatment, the levels of Hb in both groups increased significantly compared with those before treatment, and the levels of Alb and PA in the observation group were higher than those in the control group (P <0.01) Before treatment, the Scr level in observation group was lower than that in control group (P <0.01). Conclusion: The therapy of Shenkang injection can protect the residual renal function of uremic hemodialysis patients, and can delay the deterioration of renal function. It deserves further study.