斜线超滤模式联合参附注射液对透析相关性低血压预防作用的临床研究  

Clinical Study of Oblique Ultrafiltration Model Combined with Shenfu Injection on Intradialytic Hypotension

作　　者：梁一鸣[1] LIA NG Yiming(Foshan Hospital of Traditional Chinese Medicine, Guangdong, Foshan 528000, Chin)

机构地区：[1]广东省佛山市中医院,广东佛山528000

出　　处：《中国中医急症》2017年第7期1235-1237,共3页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省佛山市卫生局课题(2015286)

摘　　要：目的观察斜线超滤模式联合参附注射液对透析相关性低血压(IDH)的预防作用,探讨其预防机制。方法 60例容易在透析过程中出现低血压的患者随机分成直线超滤组、斜线超滤组和斜线超滤联合参附注射液组,各20例。观察3组患者治疗前后的血红蛋白(HGB)、尿素氮(BUN)、肌酐(Cr)、钠尿肽前体(NTpro BNP)和治疗过程中低血压发生率,比较3组患者的临床疗效,追踪随访3个月内患者的心脑血管事件发生率。结果 3组患者治疗前后的BUN和Cr水平差异无统计学意义(P>0.05)。斜线超滤模式联合参附注射液组治疗后的HGB水平显著高于其他两组(P<0.05),治疗后的APACHEⅡ评分、NT-pro BNP低于直线超滤组、斜线超滤组(P<0.05),其心脑血管事件发生率显著低于直线超滤组(P<0.05)。斜线超滤模式联合参附注射液组的临床总有效率高于其他两组(P<0.05)。结论斜线超滤模式联合参附注射液可改善透析患者的心功能,减少透析相关性低血压的发生率,同时减少心脑血管并发症。Objective： To observe the preventive effect of oblique ultrafiltration and Shenfu Injection on intradialytic hypotension（IDH）,and explore the prevention mechanism. Methods： 60 patients with hypotension during hemodialysis were randomly divided into three groups： the linear ultrafiltration model group,the oblique ultrafiltration model group and the group of oblique ultrafiltration model combined with Shenfu Injection,20 cases in each. Hemoglobin（HGB）,urea nitrogen（BUN）,creatinine（Cr） and natriuretic peptide precursors（NT-pro BNP）were measured before and after treatment in the 3 groups. The clinical efficacy was compared and the incidence of cardio cerebrovascular events in 3 months was followed up. Results： There was no significant difference in BUN and Cr among the 3 groups before and after treatment（P 0.05）. The levels of HGB were significantly higher in the group of oblique ultrafiltration model combined with Shenfu Injection after treatment than in the other two groups（P 0.05）. After treatment,the scores of APACHEⅡ and the levels of NT-pro BNP were lower than those of the linear ultrafiltration model group and the oblique ultrafiltration model group（P 0.05）. The incidence of cardio cerebral vascular events was significantly lower than that of the linear ultrafiltration model group. The total effective rate in the group of oblique ultrafiltration model combined with Shenfu Injection was higher than that of the other two groups（P 0.05）. Conclusion： Oblique ultrafiltration combined with Shenfu Injection can improve the cardiac function of dialysis patients,and reduce the incidence of IDH and cardiocerebral vascular complication.

关 键 词：斜线超滤模式 参附注射液 透析相关性低血压 临床疗效 

分 类 号：R544.2[医药卫生—心血管疾病]