复方α酮酸联合抗氧化剂治疗慢性透析低血压状态  

Treatment of chronic hypotension in maintenance hemodialysis patients with compound α-ketoacid plus antioxidant

作　　者：韩志武[1] 闫利忠[1] 李靖[1] 汪婧[1] 徐友平[1] 沈俊[1] 夏小红[1] 姚国乾[1] 

机构地区：[1]中国人民解放军第161医院,全军血液净化中心,湖北武汉430010

出　　处：《中华高血压杂志》2011年第2期120-124,共5页Chinese Journal of Hypertension

摘　　要：背景慢性透析低血压状态可直接影响维持透析患者的生活质量,与预后有直接关系。我们既往的研究发现患者的异常营养代谢及持续存在的微炎症状态是其重要影响因素。目的探讨复方α酮酸联合抗氧化剂对维持性血透(MHD)患者合并慢性低血压状态的治疗效果。方法 52例合并慢性低血压状态的MHD患者,随机分成2组,对照组采用透析模式调整及左卡尼丁、盐酸米多君治疗,治疗组在此基础上加用复方α酮酸及抗氧化剂(普罗布考),疗程6月,观察患者血液透析治疗时的基础血压,分别检测治疗前后患者的干体质量、上臂周长、改良定量主观评估表(MQSGA)评分、血清蛋白、血红蛋白、C反应蛋白(CRP)、透析充分性(Kt/V)。结果治疗前两组间各检测指标的差异均无统计学意义(P>0.05);治疗后两组患者血压指标均升高(均P<0.05),组间比较治疗组改善更明显(P<0.05)。此外治疗组患者平均干体质量、上臂周长平均值较治疗前升高(均P<0.05),改良SGA评分较治疗前明显下降(P<0.01);对照组以上各项均无变化,治疗组与对照组比较,差异有统计学意义(均P<0.05)。血清蛋白、血红蛋白治疗前后两组间均无显著差异(均P>0.05)。治疗后治疗组CRP水平低于对照组(P<0.05),Kt/V高于对照组(P<0.05)。结论复方α酮酸联合抗氧化剂通过对MHD患者营养代谢和微炎症状态的改善,可有效缓解患者慢性低血压状态,提高患者透析质量。Background Chronic hypotension state correlates closely with the quality of life in patients on maintenance dialysis.Our previous study found that abnormal nutrient metabolism and the persistence of micro-inflammatory state are important contributing factors.Objective To observe the effect of compound α-ketoacid plus antioxidant on maintenance hemodialysis MHD related hypotension.Methods Fifty-two MHD patients with chronic hypotension were randomly divided into 2 groups.In control group,patients were treated with hemodialysis,Levocarnitine and Gutron.In treatment group,additional compound α-ketoacid and antioxidant（Probucol）were added.The course of treatment was 6 months.Patients＇ baseline blood pressure during hemodialysis was observed and their dry weight,arm muscle circumference（AMC）,modified SGA score,albumin（ALB）,hemoglobin（Hb）,C reactive protein（CRP）and hemodialysis sufficiency（Kt/V）were determined.Results At baseline,all indexes in both groups showed no significant difference（P 0.05）.After treatments,blood pressures in both groups increased significantly（P 0.05）.Compared to control group,blood pressure in the treatment group increased more signifcantly（P 0.05）.In addition,compared to baseline,in treatment group,dry weight and AMC increased significantly（P 0.05）;modified SGA score decreased significantly（P 0.05）,while the control group showed no differences.The differences in these indexes between control and treatment group were statistically significant（P 0.05）.Compared to baseline,neither group showed significant difference in ALB and Hb（P 0.05）.At the end of this study,treatment group showed significant lower level of CRP（P 0.05）and significant higher Kt/V than control（P 0.05）.Conclusion By regulating the nutrition,metabolism and the status of micro-inflammation compound α-ketoacid plus antioxidant can treat the chronic hypotension effectively and improve the quality of hemodialysis for MHD patients.BG）W]

关 键 词：复方Α酮酸 抗氧化剂 维持性血液透析 低血压状态 

分 类 号：R692.5[医药卫生—泌尿科学]