复方α酮酸联合黄芪颗粒剂对血液透析患者MIA综合征的影响

The Effect of Compound α-keto Acid Combined with Astragalus Granules in Treating MIA Syndrome in Hemodialysis Patients

目的探讨复方α酮酸联合黄芪颗粒剂对血液透析患者动脉粥样硬化(MIA)综合征的影响。方法将40例血液透析MIA综合征患者随机分为对照组和复方α酮酸联合黄芪颗粒剂治疗组,每组20例,对照组给予血液透析、纠正水、电解质及酸碱平衡紊乱、控制血压、纠正贫血等治疗,治疗组在对照组基础上连续应用复方α酮酸联合黄芪颗粒剂4个月。观察2组血常规(RBC、Hb、HCT)、肝肾功能、清蛋白(ALB)、转铁蛋白(TRF)、前清蛋白(PA)、C反应蛋白(CRP)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、同型半胱氨酸(Hcy)、颈总动脉内-中膜厚度(IMT)等指标变化。结果 1对照组治疗前后RBC、Hb、HCT差异无统计学意义,治疗组治疗后RBC、Hb、HCT较治疗前及对照组明显升高(P<0.05);2对照组治疗前后ALB、TRF、PA水平差异无统计学意义,治疗组治疗后ALB、TRF、PA水平较治疗前及对照组明显升高(P<0.05);3对照组治疗前后CRP、hs-CRP、TNF-α水平差异无统计学意义,治疗组治疗后CRP、hs-CRP、TNF-α水平较治疗前及对照组明显降低(P<0.05);4对照组治疗前后颈动脉IMT及Hcy水平差异无统计学意义,治疗组治疗后颈动脉IMT及Hcy水平较治疗前及对照组明显降低(P<0.05)。结论复方α酮酸联合黄芪颗粒剂可有效控制血液透析患者MIA综合征的进展。

Objective To investigate the therapeutic effect of compound a-keto acid combined with astragalus granules in treating MIA syndrome in hemodialysis patients. Methods 40 hemodialysis patients with MIA syndrome were allocated into control and treatment group randomly, 20 patients in each group. Patients in control group were given conventional treatment, such as hemodialysis, correcting water, electrolyte and acid-base balance disorders,controling blood pressure, correcting anemia. Compound α-keto acid and astragalus granulesin were ad- ministered continuously for 4 months in treatment group in addition to the conventional treatment. The indices of blood routine,liver and kidney function, prealbumin,C reactive protein, high sensitive C reactive protein, homoeysteine,TNF-α,and carotid artery intima-media thickness were observed. Results ①After treatment, the index of RBC,Hb, HCT in treatment group increased significantly compared with pre-treatment and control group （P〈 0.05） ,and those had no significant change before and after treatment in control group（P〉0.05）. ②Aftet treatment, the level of ALB, transferrin, prealbumin in treatment group increased significantly compared with pre-treat- ment and control group（P〈0.05） ,and those had no significant change before and after treatment in control group （P〈0.05）. ③Aftet treatment, the level of CRP, hs-CRP, TNF-α in treatment group decreased significantly compared with pre-treatment and control group（P〈0.05）,and those had no significant change before and after treatment in control group（P〉0. 05）. ④Aftet treatment,the index of arotid artery intima-media thickness and homocysteine in treatment group decreased significantly compared with pre-treatment and control group（P〈0. 05）,and those had no significant change before and after treatment in control group（P〈0. 05）. Conclusion Compound α-keto acid combined with astragalus granules could effectively control the progress of MIA syndrome in hemodialysis patients.