肾康注射液对尿毒症血液透析患者残余肾功能的影响

Influence of Shenkang Injection in Treating Residual Renal Function in Hemodialysis Patients with Uremia

目的:探讨肾康注射液维持治疗对尿毒症血液透析患者残余肾功能的保护作用及其作用机制。方法:将进行血液透析的86例尿毒症患者随机按数字表法分为对照组和观察组各43例。对照组积极处理原发病,给予血液透析治疗,并以营养支持、纠正贫血和控制血糖、血压等常规治疗。观察组在对照组治疗的基础上加用肾康注射液80 m L,静脉滴注,1次/d。连续4周为1个疗程,停药4周后,再进行下1个疗程,共计6个疗程。观察治疗前、治疗后6个月和12个月残余肾功能(RRF)和尿量;计算RRF和尿量下降速度;计算一级终点事件(24 h尿量≤400 m L)的发生率;观察治疗前后血压(BP),体重(BW),血尿素氮(BUN),肌酐(Cre),血红蛋白(Hb),白蛋白(Alb),前白蛋白(PA)变化情况。结果:观察组在治疗后6,12个月RRF和尿量均高于对照组(P<0.01);在平均12个月的观察期间,观察组RRF与尿量下降速率低于对照组(P<0.01);观察组收缩压和舒张压的水平均低于对照组(P<0.01);观察组一级终点事件的发生率为20.9%,低于对照组的44.18%(P<0.05);治疗后两组Hb较治疗前升高,观察组升高更明显(P<0.01);治疗后观察组Alb和PA水平高于对照组(P<0.01);治疗后两组BUN和Scr均比治疗前下降,治疗后观察组Scr水平低于对照组(P<0.01)。结论:肾康注射液维持治疗对尿毒症血液透析患者残余肾功能具有一定的保护作用,能延缓其恶化速度,值得进一步的研究。

Objective： To discuss the protective effect of Shenkang injection on residual renal function of patients with uremia after hemodialysis. Method： Eighty-six patients with uremia after hemodialysis were randomly divided into the control group （43 cases） and the observation group （43 cases） by a random number table. In order to control the primary diseases, patients in the control group received hemodialysis, nutritional support, treat anemia, blood glucose and blood pressure （BP） control Based on the treatment of the control group, patients in the observation group added 80 mL Shenkang injection by intravenous infusion once daily. All patients received 6-, 4-week periods of treatment separated by 4 weeks without treatment each period. Before and 6-, 12- month treatment, residual renal function （RRF） and urine volume were detected. Falling speed of RRF and urine volume were calculated. Incidence rate of privary endpiont （24-hours urine volume ≤ 400 mL） was calculated. Before and after treatment, BP, body weight （BW）, blood urea nitrogen （BUN）, creatinine （Cre）, hemoglobin （Hb）, albumin （Alb） and prealbumin （PA） were observed. Result： RRF and urine volume in the observation group were superior to those in the control group after 6-, 12-month treatment （P 〈 0.01 ）. The declining rates of RRF and urine volume in the observation group were lower than those in the control group during 12 months （P 〈 0.01 ）. Levels of systolic BP and diastolic BP in the observation group were lower than those in the control group （P 〈 0.01 ）. The incidence of the primary end point event was 20.9% in the observation, while which was 44. 18% in the control group （P 〈0.05）. After therapy, Hb standard in two groups went up, while the result wasmore obvious in the observation group （P 〈 0.01 ）. Alb and PA levels those in the control group （P 〈0. 01 ）. After treatment, BUN and Scr result was lower in the observation group （P 〈 0.01 ）. Conclusion： treating residual renal function with uremia patients after hemodialysis. in the observation group were higher than standard in two groups declined, while the Shenkang injection has protective effect in It could delay the deterioration speed of the disease and deserves further study.