α-酮酸辅助CVVH联合HP治疗糖尿病并慢性肾衰的糖化白蛋白水平、营养状态及疗效分析  

Analysis of Glycosylated Albumin Level,Nutritional Status and Therapeutic Effect ofα-ketoacid-assisted CVVH Combined with HP in the Treatment of Diabetes Mellitus with Chronic Renal Failure

作　　者：胡爱霞[1] 何伟[2] HU Ai-xia;HE Wei(Department of Nephrology,the Second Hospital Urology Department Huangshi City,Huangshi 435000,China;Huangshi Central Hospital,Affiliated Hospital of Hubei Polytechnic University,Edong Healthcare Group,Huangshi 435000,China)

机构地区：[1]湖北省黄石市第二医院肾内科,湖北黄石435000 [2]鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)老年科,湖北黄石435000

出　　处：《药物生物技术》2020年第4期333-336,共4页Pharmaceutical Biotechnology

摘　　要：分析α-酮酸辅助连续性血液滤过(Continuous vena-venous hemofiltration,CVVH)联合血液灌流(Hemoperfusion,HP)治疗糖尿病并慢性肾衰的糖化白蛋白水平、营养状态及疗效。收集2016年8月至2018年8月于该院接受CVVH联合HP治疗的82例糖尿病并慢性肾衰患者,随机分为研究组与对照组,其中对照组患者40例给予单独低蛋白饮食,研究组患者42例则在给予低蛋白饮食的基础上辅助α-酮酸治疗。分析比较两组患者治疗前后的糖化白蛋白(Glycated albumin,GA)水平、糖化血红蛋白(Glycated hemoglobin,Hb A1c)、营养状态及疗效。与对照组患者的总有效率(77.5%)相比,研究组患者的总有效率(92.9%)明显更高(P<0.05);治疗后,两组患者的GA、Hb A1c水平均较治疗前明显降低(P<0.05),且研究组患者GA水平低于对照组患者(P<0.05),但两组间Hb A1c水平差异无统计学意义(P>0.05);治疗后,研究组患者的Hb、Alb、PA、BMI均较治疗前明显增加(P<0.05),且研究组患者较对照组患者更高(P<0.05)。α-酮酸辅助CVVH联合HP治疗糖尿病并慢性肾衰,可降低患者的GA与Hb A1c水平,稳定血糖,改善患者的营养状况与肾脏功能,提高治疗效果。To analyzeα-ketoacid-assisted continuous hemofiltration(CVVH)combined with hemoperfusion(HP)in the treatment of diabetes and chronic renal failure with glycated albumin levels,nutritional status and efficacy,the author collected 82 patients with diabetes and chronic renal failure who were treated with CVVH and HP in the hospital from August 2016 to August 2018.They were randomly divided into the study group and the control group.Among them,40 patients in the control group were given a low-protein diet alone,and 42 patients in the study group were assisted withα-ketoacid therapy on the basis of a low-protein diet.Glycated albumin(GA)levels,glycated hemoglobin(Hb A1 c),nutritional status and efficacy were compared before and after treatment between the two groups.The total effective rate(92.9%)was significantly higher in the study group than in the control group(77.5%)(P<0.05);After treatment,the levels of GA and Hb A1 c in the two groups were significantly lower than those before treatment(P<0.05),and the GA level in the study group was lower than that in the control group(P<0.05).There was no significant difference in Hb A1 c levels between the two groups(P>0.05);After treatment,the Hb,Alb,PA,and BMI of the study group were significantly higher than those before treatment(P<0.05),and the study group was higher than the control group(P<0.05).Alpha-ketoacid-assisted CVVH combined with HP in the treatment of diabetes and chronic renal failure can reduce the level of GA and Hb A1 c in patients,stabilize blood sugar,improve the nutritional status and renal function of patients,and improve the therapeutic effect.

关 键 词：糖尿病 慢性肾功能衰竭 Α-酮酸 连续性血液滤过 血液灌流 营养状态 

分 类 号：R587.1[医药卫生—内分泌]