连续肾替代与血液透析治疗2型糖尿病并重症肾衰竭疗效及安全性分析  

Clinical Efficacy and Safety of Continuous Renal Replacement and Hemodialysis in the Treatment of Type 2 Diabetes Mellitus Complicated with Severe Renal Failure

作　　者：马晓华 周亚男[2] 王荣荣[2] 聂屾[1] 李石磊 王博[1] 李勇[1] MA Xiaohua;ZHOU Yanan;WANG Rongrong;NIE Can;LI Shilei;WANG Bo;LI Yong(Department of Emergency Medicine, Central Hospital of Cangzhou, Cangzhou Hebei 061001, China)

机构地区：[1]沧州市中心医院急诊医学部,河北沧州061001 [2]沧州市中心医院内分泌一科

出　　处：《解放军预防医学杂志》2018年第9期1138-1140,1144,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：河北省卫生厅科研基金项目(No.20181532)

摘　　要：目的探讨连续肾替代与血液透析治疗2型糖尿病并重症肾衰竭的疗效及安全性。方法收集我院2015年1月-2017年3月期间收治的64例行血液透析的2型糖尿病并重症肾衰竭患者作为研究对象,根据随机数字表法将64例患者分为对照组和研究组,各32例,研究组患者给予持续肾替代(CRRT)治疗,对照组患者给予普通血液透析(HD)治疗。观察并记录两组患者治疗3个月后血糖、肾功能、不良反应及治疗1年后临床总有效率和存活率。结果 (1)研究组临床总有效率(62.50%)和存活率(75.00%)均明显高于对照组,差异有统计学意义(P<0.05);(2)两组患者治疗后FGB、2h PG、Hb A1c水平较治疗前均明显改善(P<0.05),且研究组患者治疗后血糖抑制程度优于对照组,存在明显差异(P<0.05);(3)两组患者治疗后Scr、BUN水平均较治疗前明显降低(P<0.05),且研究组患者降低更明显(P<0.05);(4)观察组不良反应发生率(43.75%)明显低于对照组(71.88%),具有统计学差异(P<0.05)。结论连续肾替代治疗2型糖尿病并重症肾衰竭患者可显著提高治疗效果和生存率,改善临床指标和肾功能。Objective To investigate the clinical efficacy and safety of continuous renal replacement and hemodialysis in the treatment of type 2 diabetes mellitus complicated with severe renal failure. Methods Sixty-four patients with type 2 diabetes mellitus and severe renal failure who were treated with hemodialysis between January 2015 and March 2017 were collected,who were equally divided into the control group and study group using the random number table method. Patients in the study group were treated with CRRT,while those in the control group were treated with general hemodialysis（ HD）. Blood glucose,renal function and adverse reactions were observed in the two groups after three months of treatment,and total effective rate and survival rate were recorded after one year of treatment. Results（ 1） The total effective rate（ 62.50%） and survival rate（ 75.00%） in the study group were significantly higher than those in the control group, and the difference was statistically significant（ P〈0.05）.（ 2） The levels of FGB,2 h PG,and Hb A1 c in both groups were significantly improved after treatment（ P〈0.05）,blood glucose inhibition of the study group was better than that of the control group after treatment,and there was significant difference（ P〈0.05）.（ 3） The levels of Scr and BUN in the two groups were significantly lower after treatment（ P〈0.05）,especially in the study group（ P〈0.05）.（ 4） The incidence of adverse reactions in the observation group（ 43.75%） was significantly lower than that in the control group（ 71.88%）,with statistically significant difference（ P〈0.05）. Conclusion Continuous renal replacement therapy for type 2 diabetes and severe renal failure patients can significantly enhance the therapeutic effect and survival rate while improving clinical indicators and renal function.

关 键 词：2型糖尿病 重症肾衰竭 连续肾替代 血液透析 临床疗效 不良反应 

分 类 号：R587.1[医药卫生—内分泌]