艾考糊精透析液用于糖尿病肾病患者腹膜透析的效果观察  

Efficacy of icodextrin dialysate in peritoneal dialysis for patients with diabetic nephropathy

作　　者：王雪莲[1] 周艳雪 Wang Xuelian;Zhou Yanxue(Department of Nephrology,Yiwu Central Hospital,Yiwu 322000,Zhejiang Province,China)

机构地区：[1]义乌市中心医院肾内科,义乌322000

出　　处：《中国基层医药》2024年第10期1468-1472,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省义乌市科技计划(23-3-141)。

摘　　要：目的观察艾考糊精透析液用于糖尿病肾病患者腹膜透析的临床效果。方法采用病例对照研究,选取义乌市中心医院2021年1月至2023年12月行腹膜透析的糖尿病肾病患者92例进行回顾性分析,按照透析液不同分为对照组45例、观察组47例,对照组采用葡萄糖腹膜透析液,观察组采用艾考糊精透析液,两组透析2个月。观察两组糖代谢指标、血脂指标、不良反应、容量负荷参数(舒张压、收缩压及超滤量)。结果治疗后,观察组空腹血糖、糖化血红蛋白、餐后2 h血糖、三酰甘油、低密度脂蛋白胆固醇分别为(7.56±0.97)mmol/L、(7.64±1.55)%、(8.49±1.42)mmol/L、(2.02±0.39)mmol/L、(3.10±0.47)mmol/L,均低于对照组的(8.27±1.25)mmol/L、(8.77±1.89)%、(9.39±1.64)mmol/L、(2.30±0.44)mmol/L、(3.46±0.55)mmol/L(t=3.05、3.14、2.82、3.23、3.38,均P<0.05)。观察组不良反应发生率为12.77%(6/47),低于对照组的31.11%(14/45)(χ^(2)=4.55,P<0.05)。治疗后,观察组舒张压、收缩压分别为(83.75±8.55)mmHg(1 mmHg=0.133 kPa)、(142.35±15.78)mmHg,均低于对照组的(88.79±8.90)mmHg、(156.20±16.19)mmHg,但观察组超滤量[(638.77±64.21)mL]高于对照组[(590.41±60.34)mL](t=2.77、4.16、3.72,均P<0.05)。结论糖尿病肾病患者采取艾考糊精透析液腹膜透析能够在一定程度上改善患者糖脂代谢,降低不良反应发生率,有效调整患者容量负荷状态。Objective To investigate the clinical efficacy of icodextrin dialysate in peritoneal dialysis for patients with diabetic nephropathy.Methods A case-control study was conducted to retrospectively analyze 92 patients with diabetic nephropathy who underwent peritoneal dialysis at Yiwu Central Hospital from January 2021 to December 2023.The patients were divided into two groups based on the type of dialysis solution used:the control group(n=45)received glucose-based dialysate,while the observation group(n=47)received icodextrin dialysate.Both groups underwent dialysis for 2 months.Glycemic control indicators,lipid profiles,adverse reactions,and volume overload parameters(diastolic pressure,systolic pressure,and ultrafiltration volume)were assessed in both groups.Results After treatment,fasting blood glucose,glycated hemoglobin,2-hour postprandial blood glucose,triglycerides,and low-density lipoprotein cholesterol levels in the observation group were(7.56±0.97)mmol/L,(7.64±1.55)%,(8.49±1.42)mmol/L,(2.02±0.39)mmol/L,and(3.10±0.47)mmol/L,respectively,all of which were significantly lower than those in the control group[(8.27±1.25)mmol/L,(8.77±1.89)%,(9.39±1.64)mmol/L,(2.30±0.44)mmol/L,(3.46±0.55)mmol/L,t=3.05,3.14,2.82,3.23,3.38,all P<0.05].The incidence of adverse reactions in the observation group was significantly lower than that in the control group[12.77%(6/47)vs.31.11%(14/45),χ^(2)=4.55,P<0.05].After treatment,the diastolic pressure and systolic pressure in the observation group were(83.75±8.55)mmHg(1 mmHg=0.133 kPa)and(142.35±15.78)mmHg,respectively,both of which were significantly lower than those in the control group[(88.79±8.90)mmHg,(156.20±16.19)mmHg,t=2.77,4.16,both P<0.05].However,the ultrafiltration volume in the observation group was signifiantly higher than that in the control group[(638.77±64.21)mL vs.(590.41±60.34)mL,t=3.72,P<0.05].Conclusion Peritoneal dialysis using icodextrin dialysate in patients with diabetic nephropathy can improve glucose and lipid metabolism,reduce the incidenc

关 键 词：糖尿病肾病 腹膜透析 透析液 碳水化合物代谢 脂类代谢 血压 血糖 甘油三酯类 胆固醇 

分 类 号：R587.2[医药卫生—内分泌] R692.5[医药卫生—内科学]