腹膜透析液中添加黄芪对透析效能的影响  

Effects of astragalus on peritoneal dialysis efficiency in continuous ambulatory dialysis patients

作　　者：孙 张苗[1] 蒋春明[1] 

机构地区：[1]南京大学医学院附属鼓楼医院肾脏科,210008

出　　处：《江苏医药》2005年第4期258-260,共3页Jiangsu Medical Journal

基　　金：江苏省社会科技发展基金(BS2002003)

摘　　要：目的观察在腹膜透析液中添加黄芪注射液对患者透析效能的影响。方法采用自身对照的方法,28例终末期肾脏病持续非卧床腹膜透析(CAPD)患者,在腹膜透析液中添加黄芪注射液(10 ml/L),观察期9 d,对比用药前后腹膜对尿素氮和肌酐转运、葡萄糖重吸收率、24 h净超滤量以及透出液白蛋白水平和透析充分性指标的变化。结果在腹膜透析液中添加黄芪注射液后,4 h尿素氮、肌酐透出液与血浆比(D/P)值显著升高[(0 82±0 09) vs (0 89±0 08),P<0 01;(0 65±0 12) vs (0 71±0 10),P<0 05]尿素氮、肌酐溶质转运面积系数(MTAC,ml·min 1 ·1 73m 2)明显升高[(16 58±5 15)vs (22 51±7 53),P<0 01;(9 53±3 65) vs (11 44±3 22),P<0 05]。用药后患者周腹膜尿素氮清除指数和肌酐清除率(KT/V和Ccr,L·周1·1 73m2)明显增高[(1 42±0 34) vs (1 68±0 37),P<0 05;(36 81±7 13) vs (41 93±6 21),P<0 05]。用药前后患者周残余肾KT/V和Ccr无明显变化,葡萄糖重吸收率无明显变化。用药前后患者24 h净超滤量显著升高[(535±397) vs (931±485)(ml/24 h),P<0 01],透出液β2 微球蛋白及白蛋白含量无明显改变。结论腹膜透析液中添加黄芪注射液可以提高患者腹膜对尿素氮、肌酐和水的清除,能提高患者的透析效能且不增加白蛋白的流失和?Objective To investigate the effects of astragalus on peritoneal dialysis efficiency in patients undergoing continuous ambulatory peritoneal dialysis(CAPD).Methods 28 stable CAPD ~patients were included in this study.At first,the marks such as dialysate-to-plasma ratios(D/P)at 4 hours and mass transfer area coefficients(MTAC)of urea and creatinine,glucose reAbsorption ratio,24-hour net ultrafiltration,albumin and β_2-microglobulin concentration in serum and effluent and KT/V,creatinine clearance rate(Ccr)were calculated.Then,by using the peritoneal dialysis fluid containing astragalus(10ml/L)in vivo for one week,the marks mentioned above were calculated again and compared with the results before.Results After using astragalus in peritoneal dialysis fluid,the levels of 4-hour D/P and MTAC of urea and creatinine were significanty higher than those before treatmnent(P<0.01).Significant increase could also be found in p KT/V and p Ccr as compared with the beginning respectively,while no significant changes in r KT/V and r Ccr were found.Glucose reAbsorption ratio was slightly elevated [(59.4%±10.1%) vs (62.9%±11.8%)(P>0.05)].Significant increase of 24-hour net ultrafiltration was found after using astragalus in vivo(535±397 vs 931±485ml).There was no significant difference found in serum and effluent albumin concentrations as compared with those one week before.Similar results were found in β_2-microglobulin,although there was a slight increase in peritoneal clearances of β_2-microglobuling.Conclusion The addition of astragalus into peritoneal dialysis fluid can not only increase peritoneal clearances of urea and creatinine,but also increase the ~amount of removal fluid in continuous ambulatory dialysis patients,and improve peritoneal dialysis ~efficiency. At the same time,astragalus does not increase peritoneal clearances of serum albumin and glucose reAbsorption.

关 键 词：腹膜透析液 透析效能 添加 持续非卧床腹膜透析 黄芪注射液 终末期肾脏病 KT/V 尿素氮 充分性指标 肌酐清除率 β2微球蛋 用药前 葡萄糖 透出液 自身对照 蛋白水平 溶质转运 0.05 蛋白含量 吸收率 超滤量 24h Ccr 患者 

分 类 号：R459.5[医药卫生—治疗学] R155.5[医药卫生—临床医学]