间歇性腹膜透析治疗尿毒症脑病的疗效观察  

The observation of the efficacy of intermittent peritoneal dialysis in the treatment of uremia encephalopathy

作　　者：孙希锋 高慧[2] 张云静[1] 林静[3] Sun Xifeng;Gao Hui;Zhang Yunjing(*Department of Nephrology,Zibo Central Hospital,Zibo Shandong255036;不详)

机构地区：[1]山东省淄博市中心医院肾内科,255036 [2]山东省淄博市中心医院泌尿外科,255036 [3]陕西省人民医院心内科

出　　处：《卒中与神经疾病》2020年第4期484-487,共4页Stroke and Nervous Diseases

基　　金：国家自然科学基金(81400333)。

摘　　要：目的探讨间歇性腹膜透析对长期维持腹膜透析患者尿毒症脑病的治疗效果。方法选择2013年1月-2018年12月本院肾内科长期维持腹膜透析出现尿毒症脑病患者46例,并随机分为持续性不卧床腹膜透析(Continuous ambulatory peritoneal dialysis,CAPD)组及间歇性腹膜透析(Intermittent peritoneal dialysis,IPD)组,在治疗前及治疗7 d后分别采血进行血肌酐(Scr)、尿素氮(BUN)、甲状旁腺激素(iPTH)、白细胞介素6(IL-6)、β2微球蛋白(β2-MG)、超敏C反应蛋白(CRP)水平的检测,采用阳性与阴性症状量表评分表(PAN-SS)评价患者的疗效。结果 CAPD组治疗后血BUN、Scr、iPTH、IL-6、β2-MG、CRP水平与治疗前比较无明显变化(P>0.05);IPD组治疗后血BUN、Scr水平与治疗前比较无明显变化(P>0.05),而iPTH、IL-6、β2-MG、CRP水平较治疗前明显下降(P<0.05);治疗后IPD组iPTH、IL-6、β2-MG、CRP水平与CAPD组比较有明显差异(P<0.05);PAN-SS显示,IPD组与CAPD组阳性症状、阴性症状、一般精神症状等方面均有明显差异(P<0.05);CAPD组无效8例,好转12例,显著进步4例,基本痊愈2例;IPD组无效2例,好转14例,显著进步5例,基本痊愈5例。结论规律腹膜透析患者出现尿毒症脑病时应用间歇性腹膜透析治疗效果优于持续不卧床腹膜透析。Objective To investigate the therapeutic effect of intermittent peritoneal dialysis on uremia encephalopathy in patients with long-term maintenance peritoneal dialysis.Methods From January 2013 to December 2018, 46 patients with uremia encephalopathy who underwent long-term maintenance peritoneal dialysis in our department of nephrology were selected. They were randomly divided into CAPD group and IPD group. Blood was collected before treatment and after 7 days of treatment for serum creatinine(Scr), urea nitrogen(BUN), parathyroid hormone(iPTH), interleukin 6(IL-6), β2 microglobulin(β2-MG), high-sensitivity C-reactive protein(CRP) level detections. The positive and negative symptom scale score(PAN-SS) was used to evaluate the efficacy of treatment. Results There were no significant differences in blood BUN, Scr, iPTH, IL-6, β2-MG, and CRP levels in the CAPD group before and after treatment(P>0.05). There were no significant changes in blood BUN and Scr in the IPD group before and after treatment( P>0.05), and the levels of iPTH, IL-6, β2-MG, and CRP were significantly lower after treatment than those before treatment(P<0.05). After treatment, the levels of iPTH, IL-6, β2-MG, and CRP in the IPD group were higher than those in the CAPD group(P<0.05). PAN-SS showed that there were statistically significant differences in positive symptoms, negative symptoms, and general psychopathology between the IPD group and the CAPD group(P<0.05). In the CAPD treatment group 8 cases were invalid, 12 cases were improved, 4 cases were significantly improved, and 2 cases were basically cured. In the IPD group, 2 cases were invalid, 14 cases were improved, 5 cases were significantly improved, and 5 cases were basically cured. Conclusion When uremia encephalopathy occurred in patients with regular peritoneal dialysis, intermittent peritoneal dialysis was better than continuous ambulatory peritoneal dialysis.

关 键 词：尿毒症脑病 间歇性腹膜透析 持续不卧床腹膜透析 

分 类 号：R747.9[医药卫生—神经病学与精神病学]