司维拉姆联合血液灌流治疗血液透析患者顽固性皮肤瘙痒症的临床研究

Clinical study on sevelamer combined with hemoperfusion in treatment of hemodialysis patients with intractable cutaneous pruritus

目的探究司维拉姆联合血液灌流治疗血液透析患者顽固性皮肤瘙痒症的临床价值。方法选取2018年12月至2020年6月于本院行血液透析治疗>3个月且合并顽固性皮肤瘙痒患者50例作为研究对象,按照随机数字表法分为两组,每组25例。对照组给予血液灌流治疗,观察组在对照组基础上给予司维拉姆治疗。比较两组临床疗效、血清因子、皮肤瘙痒评分及不良反应发生率。结果治疗后,观察组瘙痒症状缓解率(96.00%)高于对照组(80.00%),但差异无统计学意义;观察组改良Duo氏瘙痒评分、血清磷(P)、甲状旁腺素(PTH)、肌酐(SCr)、尿素氮(BUN)均低于对照组,差异具有统计学意义(P<0.05);两组血清钙(Ca)、不良反应发生率比较差异无统计学意义。结论司维拉姆联合血液灌流治疗血液透析患者的顽固性皮肤瘙痒效果显著,可明显改善患者的临床瘙痒症状。

Objective To investigate the clinical value of sevelamer combined with hemoperfusion in treatment of hemodialysis patients with intractable cutaneous pruritus.Methods 50 patients with intractable cutaneous pruritus who underwent hemodialysis treatment 3 months in our hospital from December 2018 to June 2020 were selected as the research subjects,and they were divided into two groups according to the random number table method,with 25 cases in each group.The control group was given hemoperfusion treatment,and the observation group was given sevelamer treatment on the basis of the control group.The clinical efficacy,serum factors,skin pruritus score and the incidence of adverse reactions were compared between the two groups.Results After treatment,the remission rate of cutaneous pruritus in the observation group(96.00%)was higher than that of the control group(80.00%),but the difference was not statistically significant;the modified Duo’s pruritus score,serum phosphorus(P),parathyroid hormone(PTH),and serum creatinine(SCr)and blood urea nitrogen(BUN)in the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05);there was no significant difference in the incidence of serum calcium(Ca)and adverse reactions between the two groups.Conclusion Sevelamer combined with hemoperfusion in treatment of hemodialysis patients with intractable cutaneous pruritus has significant efficacy of improving clinical pruritus symptoms.