复方α酮酸片联合HFHD在尿毒症维持性血液透析患者中的应用观察

Application of compoundα-ketoacid tablets combined with HFHD in maintenance hemodialysis patients with uremia

目的:探讨复方α酮酸片联合高通量血液透析(HFHD)在尿毒症维持性血液透析患者中的应用效果。方法:选取某院尿毒症维持性血液透析患者98例,依据随机数字表法分为研究组和对照组,每组49例。对照组采取HFHD治疗,研究组在对照组基础上加用复方α酮酸片。统计2组患者治疗前及治疗6个月后人体测量学指标[上臂周径(MAC)、肱三头肌皮褶厚度(TSF)、体质量指数(BMI)]、营养评分[营养不良炎症评分(MIS)、主观综合性营养评分(SGA)]、血清炎性因子(IL-6、TNF-α、hs-CRP)、前白蛋白(PA)、白蛋白(ALB)水平及钙磷代谢指标[甲状旁腺素(iPTH)、磷(P)、钙(Ca)]。结果:治疗后研究组MAC、TSF、BMI大于对照组,MIS、SGA评分低于对照组(P<0.05);研究组血清IL-6、TNF-α、hs-CRP水平低于对照组,血清PA及ALB水平高于对照组(P<0.05);治疗后研究组血清iPTH、P水平低于对照组(P<0.05)。结论:复方α酮酸片联合HFHD对尿毒症患者实施干预,可有效调节钙磷代谢水平及体内炎性反应程度,改善营养状态。

Objective:To investigate the application effect of compoundα-ketoacid tablets combined with high flux hemodialysis(HFHD)in uremic maintenance hemodialysis patients.Methods:98 patients with uremic maintenance hemodialysis in a hospital were selected and randomly divided into an observation group and a control group,each with 49 cases.The control group was treated with HFHD,and the observation group was treated with compoundα-ketoacid tablets on the basis of the control group.The two groups were compared before the treatment and 6 months after the treatment in terms of anthropometric indexes[upper arm circumference(MAC),triceps skinfold thickness(TSF),body mass index(BMI)],malnutrition inflammation score(MIS),subjective comprehensive nutrition score(SGA),serum inflammatory factors(IL-6,TNF-α,hs-CRP),prealbumin(PA)levels,albumin(ALB)levels,and calcium and phosphorus metabolism indicators[parathyroid hormone(iPTH),phosphorus(P),calcium(CA)]levels.Results:After the treatment,MAC,TSF,BMI in the observation group were higher than those in the control group,while MIS and SGA scores were lower than those in the control group(P<0.05);serum IL-6,TNF-α,and hs-CRP levels in the observation group were lower than those in the control group,while serum PA and ALB levels were higher than those in the control group(P<0.05);serum iPTH and P levels in the observation group were lower than those in the control group(P<0.05).Conclusion:Combination of compoundα-ketoacid tablets and HFHD can effectively regulate the metabolism of calcium and phosphorus and the degree of inflammatory reaction in vivo,thus improving the nutritional status of uremic patients.