终末期肾病患者金刚烷胺引起的药物性脑病血液净化治疗的效果  

Efficacy of blood purification therapy in treatment of end-stage renal disease patients with encephalopathy caused by amantadine

作　　者：李亚光[1] 陈贺[1] 穆永芳[1] 郭琼杰[1] 李慧妍[1] 王丽辉[1] 李洋[1] 

机构地区：[1]河北省秦皇岛市第一医院,河北秦皇岛066000

出　　处：《实用临床医药杂志》2015年第15期18-22,共5页Journal of Clinical Medicine in Practice

摘　　要：目的探讨终末期肾病患者伴金刚烷胺药物性脑病患者应用血液透析(HD)、血液透析滤过(HDF)、血液透析灌流治疗的临床效果。方法选取接受透析治疗的终末期肾病患者103例,均伴金刚烷胺药物性脑病,将其随机分成A组、B组、C组及对照组,分别行HD、HDF、HP+HD透析治疗及停药干预。采用LC-MS法测定血液透析前后的血浆金刚烷胺水平,并观察精神神经系统症状治疗效果。结果透析及干预后,4组患者金刚烷胺水平均明显下降,且B组、C组临床治疗效果均明显优于A组(P<0.05),C组明显优于B组(P<0.05)。结论 HDF、HP+HD透析治疗能明显降低终末期肾病患者血浆中金刚烷胺水平,有利于患者药物性脑病精神症状的改善。Objective To investigate the clinical effect of hemodialysis （HD）, continuous veno-venous hemodia{iltration （HI）F） and blood perfusion dialysis treatment on treatment of end- stage renal disease patients with encephalopathy caused by amantadine. Methods A total of 103 end-stage renal disease patients with dialysis treatment were selected and all of them had en- cephatopathy caused by amantadine. All patients were randomly divided into group A, group B, group C and control group, and the four groups were treated with HD, HDF, HP ＋ HI） dialysis treatment and drug withdrawal intervention respectively. The plasma levels of amantadine were measured by LC - MS method before and after hemodialysis, and the effect of mental nervous system symptoms was observed. Results After the intervention, the plasma levels of amantadine decreased in four groups, and the clinical effects of group B and group C were significantly better than the group A （P 〈0.05） and meanwhile the clinical effect of group C was significantly better than the group B （P 〈 0.05）. Conclusion HI）F, HP ＋ HD dialysis treatment can obviously reduce the plasma level of amantadine in end-stage renal disease patients with encephalopathy, and it is benefit for the improvement of the mental symptoms in patients.

关 键 词：终末期肾病 金刚烷胺 药物性脑病 血液净化 

分 类 号：R692[医药卫生—泌尿科学]