复方α-酮酸联合血液灌流对维持性血液透析患者微炎症状态、钙磷代谢及营养状况的影响  

Study on the effect of compound α- keto acid combined with blood perfusion on the status of micro- inflammation,calcium- phosphorus metabolism and nutritional condition in patients with maintenance hemodialysis

作　　者：王波[1] 

机构地区：[1]四川省广元市第一人民医院肾内科,四川广元628017

出　　处：《临床和实验医学杂志》2015年第21期1787-1790,共4页Journal of Clinical and Experimental Medicine

基　　金：2011年四川省卫生厅科研课题(编号:110245)

摘　　要：目的探讨复方α-酮酸联合血液灌流(HP)对维持性血液透析(MHD)患者微炎症状态、钙磷代谢及营养状况的影响。方法 82例MHD患者随机分为对照组(n=41)和观察组(n=41)。对照组采用常规血液透析(HD)治疗,观察组采用HD+HP治疗,同时口服复方α-酮酸片,4片/次,每日3次。对照分析两组治疗前和治疗6个月后的血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)、血钙(Ca)、血磷(P)、全段甲状旁腺素(i PTH)、血清白蛋白(Alb)、血红蛋白(Hb)、主观综合性营养评估(SGA)、体质量指数(BMI)及肱三头肌皮褶厚度(TSF)的变化。结果治疗6个月后,观察组的hs-CRP、IL-6和TNF-α水平明显低于治疗前和同时期对照组(P<0.05);两组血钙水平明显升高、血磷水平均减低,但观察组优于对照组(P<0.05),观察组治疗后的iP TH水平明显减低(P<0.05),而对照组无明显变化(P>0.05);与治疗前比较,观察组的营养状况明显改善(P<0.05),而对照组无明显变化(P>0.05)。结论复方α-酮酸联合血液灌流能明显改善MHD患者的微炎症状态、钙磷代谢和营养状况,有助于预防并发症发生。Objective To explore the effect of compound α - keto acid combined with blood perfusion（HP）on the status of micro - in-flammation,calcium - phosphorus metabolism and nutritional condition of patients with maintenance hemodialysis（MHD）. Methods Eighty two patients with MHD were randomly divided into control group（n = 41）and observation group（n = 41）,patients in control group were given with routine hemodialysis（HD）,patients in observation group were given with HD plus HP and oral administration of compound α - keto acid pieces（4 pieces/ time,tid）. The serum levels of hypersensitive C - reactive protein（hs - CRP）,tumor necrosis factor α（TNF - α）,interleukin 6（IL -6）,calcium（Ca）,phosphate（P）,intraoperative parathyroid hormone（iPTH）,serum albumin（Alb）,hemoglobin（Hb）,subjective global as-sessment（SGA）,body mass index（BMI）,and arm muscle circumference（AMC）were examined in patients of these 2 groups before and after treatment for 6 months. Results Serum levels ofhs - CRP,IL - 6 and TNF - α in patients of observation group after treatment for 6 months were obviously lower thanthose before treatment and control group at the same time（ P ﹤ 0. 05）,while these indicators in control group had no signifi-cant change（ P ﹥ 0. 05）. Serum level of calcium was obviously elevated,and level of phosphorus was reduced in both 2 groups,but they were better in observation group than control group（ P ﹤ 0. 05）. Serum level of iPTH inobservation group after treatment for 6 months was obviously reduced than that before treatment（ P ﹤ 0. 05）,while it incontrol group had no significant change（ P ﹥ 0. 05）. In comparison with control group before and after treatment for 6 months,the nutritional status of patients in observation group was significantly improved（ P ﹤ 0. 05）,but it in control group had no significant change（ P ﹥ 0. 05）. Conclusion The application of compound α - keto acid combined with blood perfusion can obviously im

关 键 词：维持性血液透析 复方Α-酮酸 血液灌流 微炎症状态 钙磷代谢 营养状况 

分 类 号：R692.5[医药卫生—泌尿科学]