血液透析联合尿毒清颗粒对终末期肾病患者蛋白结合型毒素水平的影响  

Effects of hemodialysis combined with uremic clearance granule on serum protein-bound uremic toxins in patients with end-stage renal disease

作　　者：刘猛 朱江 Liu Meng;Zhu Jiang(Department of Nephrology,Jiangning Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu 211100,China)

机构地区：[1]南京医科大学附属江宁医院肾内科,211100

出　　处：《中国基层医药》2020年第21期2613-2617,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨血液透析(HD)联合尿毒清颗粒(UCG)口服对终末期肾病患者蛋白结合型毒素水平的影响。方法选取2018年1月至2019年5月在南京医科大学附属江宁医院血液净化中心行HD的患者80例,采用随机数字表法分为HD联合UCG组、HD组各40例。HD组行常规HD治疗;HD联合UCG组在常规HD基础上口服UCG。随访观察24周,测定并比较两组患者治疗前后硫酸对甲酚(PCS)、硫酸吲哚酚(IS)水平。结果治疗前,两组PCS、IS差异均无统计学意义(均P>0.05)。治疗8周、16周、24周,HD联合UCG组PCS分别为(19.58±13.25)mg/L、(18.44±11.78)mg/L、(18.03±11.94)mg/L,IS分别为(24.28±15.36)mg/L、(23.54±15.07)mg/L、(23.69±14.83)mg/L,均低于HD组[PCS:(25.64±16.73)mg/L、(23.26±14.15)mg/L、(24.86±15.31)mg/L,IS:(36.72±19.48)mg/L、(33.59±17.38)mg/L、(33.92±16.61)mg/L],差异均有统计学意义(t=2.057、2.103、2.318,2.615、2.413、2.701,均P<0.05)。两组患者均无严重不良反应发生。结论终末期肾病患者口服UCG,可持续有效降低体内PCS、IS蛋白结合型毒素水平。Objective To evaluate the effects of hemodialysis(HD)combined with uremic clearance granule(UCG)on serum protein-bound uremic toxins in patients with end-stage renal disease(ESRD).Methods From January 2018 to May 2019,80 patients with ESRD who received maintenance HD at Jiangning Hospital Affiliated to Nanjing Medical University were allocated into HD+UCG group and HD group according to the random digital table method,with 40 cases in each group.The HD group received HD and conventional treatment,HD+UCG group was given UCG on the basis of the HD group.The follow-up lasted 24 weeks.The pre-dialysis concentration of p-cresyl sulfate(PCS)and indoxyl sulfate(IS)were measured and compared before and after treatment.Results Before treatment,there were no statistically significant differences in PCS and IS between the two groups(all P>0.05).After treatment for 8,16,24 weeks,the concentrations of PCS in the HD+UCG group were(19.58±13.25)mg/L,(18.44±11.78)mg/L,(18.03±11.94)mg/L,respectively,and the IS levels in the HD+UCG group were(24.28±15.36)mg/L,(23.54±15.07)mg/L,(23.69±14.83)mg/L,respectively,which were all lower than those in the HD group[PCS:(25.64±16.73)mg/L,(23.26±14.15)mg/L,(24.86±15.31)mg/L;IS:(36.72±19.48)mg/L,(33.59±17.38)mg/L,(33.92±16.61)mg/L],the differences were statistically significant(t=2.057,2.103,2.318,2.615,2.413,2.701,all P<0.05).And no serious adverse reactions occurred in all patients.Conclusion Administration of UCG orally can decrease the concentration of serum protein-bound uremic toxins such as PCS and IS continuously and effectively in patients with ESRD.

关 键 词：肾功能衰竭 慢性 尿毒症 心血管疾病 血液透析滤过 硫酸吲哚酚 硫酸对甲酚 肠毒素类 尿毒清颗粒 医学 中国传统 

分 类 号：R692.5[医药卫生—泌尿科学]