复方α-酮酸片与高通量血液透析治疗尿毒症患者的临床效果分析  

Analysis of clinical effect of compoundα-ketoacid tablets and high-throughput hemodialysis in the treatment of uremic patients

作　　者：刘加强 张桂萍 公超 LIU Jia-qiang;ZHANG Gui-ping;GONG Chao(Hemodialysis Room,Linyi Central Hospital,Linyi 276000,China)

机构地区：[1]临沂市中心医院血液透析室,276000 [2]临沂市中心医院麻醉科,276000

出　　处：《中国实用医药》2024年第21期12-16,共5页China Practical Medicine

摘　　要：目的 观察复方α-酮酸片与高通量血液透析治疗尿毒症患者的临床效果。方法 60例尿毒症患者,以随机数字表法分为试验组、对照组,各30例。试验组实施复方α-酮酸片与高通量血液透析治疗,对照组实施高通量血液透析治疗。对比两组治疗效果、不良事件发生率、营养状态[量化主观综合性营养评价法(Q-SGA)、营养不良-炎症反应评定(MIS)评分]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、免疫功能指标(CD3^(+)、CD4^(+))、抑郁程度[汉密尔顿抑郁量表(HAMD)评分]、焦虑程度[汉密尔顿焦虑量表(HAMA)评分]、生活质量[健康调查简表(SF-36)评分]。结果 试验组治疗总有效率(96.67%)与对照组(70.00%)对比更高(P<0.05)。试验组不良事件发生率(3.33%)与对照组(23.33%)对比更低(P<0.05)。治疗3个月后,试验组IL-6、TNF-α、CRP水平分别为(48.27±12.84)ng/L、(2.03±0.42)ng/ml、(30.26±8.34)mg/L,与对照组的(56.43±13.47)ng/L、(3.25±0.51)ng/ml、(60.39±17.31)mg/L对比更低(P<0.05)。治疗3个月后,试验组Q-SGA评分(12.36±3.51)分、MIS评分(8.43±1.21)分与对照组的(16.26±3.24)、(11.39±1.73)分对比更低(P<0.05)。治疗3个月后,试验组CD3^(+)(45.46±5.37)%、CD4^(+)(34.69±4.38)%与对照组的(40.13±5.32)%、(31.15±4.23)%对比更高(P<0.05)。治疗3个月后,试验组HAMD评分(9.84±2.13)分、HAMA评分(8.98±2.43)分与对照组的(13.85±2.26)、(12.71±2.62)分对比更低(P<0.05)。治疗3个月后,试验组心理功能评分(80.16±4.28)分、物质生活状态评分(81.28±4.61)分、社会功能评分(80.13±3.24)分与对照组的(71.37±4.64)、(72.13±4.62)、(70.92±3.13)分对比更高(P<0.05)。结论 尿毒症患者采用复方α-酮酸片与高通量血液透析治疗效果较好,能够改善患者临床症状、炎症反应及营养状态、心理状态,提升免疫功能及生活质量,适宜广泛推广。Objective To observe the clinical effect of compoundα-ketoacid tablets and high-throughput hemodialysis in the treatment of uremic patients.Methods 60 patients with uremia were divided into an experimental group and a control group using a random number table method,each consisting of 30 cases.The experimental group was given compoundα-ketoacid tablets and high-throughput hemodialysis,while the control group received high-throughput hemodialysis.Both groups were compared in terms of treatment effect,incidence of adverse events,nutritional status[Quantitative Subjective Global Assessment(Q-SGA),Malnutrition-Inflammation Score(MIS)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)],immune function indexes(CD3^(+),CD4^(+)),depression level[Hamilton Depression Scale(HAMD)score],anxiety level[Hamilton Anxiety Scale(HAMA)score],and quality of life[36-Item Short-Form Health Survey(SF-36)score].Results The total effective rate of treatment of the experimental group(96.67%)was higher than that of the control group(70.00%)(P<0.05).The incidence of adverse events in the experimental group(3.33%)was lower than that in the control group(23.33%)(P<0.05).After 3 months of treatment,the levels of IL-6,TNF-αand CRP were(48.27±12.84)ng/L,(2.03±0.42)ng/ml and(30.26±8.34)mg/L in the experimental group,which were lower than(56.43±13.47)ng/L,(3.25±0.51)ng/ml and(60.39±17.31)mg/L in the control group(P<0.05).After 3 months of treatment,the experimental group had Q-SGA score of(12.36±3.51)points and MIS score of(8.43±1.21)points,which were lower than(16.26±3.24)and(11.39±1.73)points in the control group(P<0.05).After 3 months of treatment,the experimental group^(+)^(+)had CD3 of(45.46±5.37)%and CD4 of(34.69±4.38)%,which were higher than(40.13±5.32)%and(31.15±4.23)%in the control group(P<0.05).After 3 months of treatment,the experimental group had HAMD score of(9.84±2.13)points and HAMA score of(8.98±2.43)points,which were lower than(13.85±2.26)and(12.71±2.62)point

关 键 词：复方Α-酮酸片 高通量血液透析 尿毒症 

分 类 号：R692.5[医药卫生—泌尿科学]