用彩色多普勒方法对红花注射液治疗慢性肾功能衰竭的临床研究

A clinical study on treatment of chronic renal failure with safflower injection by using color Doppler ultrasound

目的 用彩色多普勒超声方法研究红花注射液与低分子右旋糖酐合用治疗慢性肾功能衰竭疗效。方法 将慢性肾功能衰竭患者随机分为治疗组(60例)和对照组(30例),两组又分为代偿期、氮质血症期和尿毒症期亚组。治疗组采用红花注射液与低分子右旋糖酐静脉注射1次/d×14 d,对照组单用低分子右旋糖酐静脉注射1次/d×14d,用药前后采用彩色多普勒检测肾动脉血流参数,并同时检查血尿素氮(BUN)、肌酐(Scr)、内生肌酐清除率(Cr)、血小板(pt)及纤维蛋白原(Fg)及临床症状(食欲、睡眠、出血、尿量)。结果 治疗组除尿毒症期亚组外代偿期和氮质血症期亚组临床自觉症状,食欲、睡眠、尿量明显改善,Ccr上升10ml/min,彩色多普勒能量图(CDEI)肾动脉血流信号增加,肾动脉血流阻力指数(RI)下降(<0.75),总有效率为83％;而对照组各项指标均未见明显改变,总有效率为25％。结论 红花注射液与低分子右旋糖酐合用具有活血化瘀、抗凝、改善肾动脉血流参数之功效,且副作用少。彩色多普勒肾动脉血流分析为慢性肾功能衰竭患者微血管病变的检测提供了信息,为临床医生判定治疗效果及评估预后提供更完善的依据。

Objective To study the efficacy in the treatment of chronic renal failure (CRF) by combining safflower injection and dextran 40 by using color Doppler ultrasound. Methods The patients with CRF were divied into two groups ;saf flower group(60 cases) and control group (30 cases),and then the two groups were divided three sub-groups:renal insufficiency compensation (sub-group A), renal insufficiency (sub-group B)and renal failure (subgroup C). Each sub-group had been treated with safflower injection and dextran 40 via intravenous drip one time everyday for 14 days in safflower group: The control group had been only treated with dextran 40 via intravenous drip one time everyday for 14 days. Before and after the treatment, the renal artery blood flows were detected through color Doppler energy imagine (CDEI). The clinic symptom felt by patients themselves,appetite,sleep ,and the quantity of urine were observed. Results After treatment of safflower injection combined with dextran 40,the clinical symptom felt by patients themselves,appetite,sleep and the quantity of urine in the patiens of subgroup A and B have shown some improvement. Creatinine clearance rate increased to 10 ml/min. The signal of the renal artery blood flow showed by CDEI appears to be bulit up. The resistance index of the renal artery blood flow decreased to less than 0. 75. The total effectiveness in safflower group is 83%. The obvious changes in the indexes mentioned above were not observed in sub-group C and control group. The total effectiveness in control group is 25%. Conclusion Treatment of safflower injection combined with dextran 40 can achieve accelerating circulation,e-liminating bump,resisting thrombosis and improving the indexes of the renal artery blood flow just with a little side effect. Analyzing the renal artery blood flow through color Doppler can provide clinic doctors more perfect basis for judging the effect of a therapy and evaluating prognosis.