贝前列素钠联合前列地尔对血液透析患者肾功能及血清全段甲状旁腺素、白细胞介素-13、白细胞介素-18水平的影响

Effects of Beraprost Sodium Combined with Alprostadil on Renal Function and Serum iPTH,IL-13,IL-18 Levels in Hemodialysis Patients

目的:探讨贝前列素钠联合前列地尔对血液透析患者肾功能及血清全段甲状旁腺素(iPTH)、白细胞介素-13(IL-13)、白细胞介素-18(IL-18)水平的影响。方法:选择156例行血液透析的CRF患者为研究对象,以随机数字表法将患者分为对照组(贝前列素钠片治疗)78例,观察组(贝前列素钠+前列地尔治疗)78例,并评价两组患者临床疗效,比较两组患者治疗前后血清肌酐(Scr)、血尿素氮(BUN)、24 h尿蛋白定量(24 hUP)、全段甲状旁腺素(iPTH)水平及血浆纤维蛋白原(Fib)、部分凝血活酶时间(aPTT)、凝血酶原时间(PT)、D-二聚体(D-D)水平。测定肾动脉血流动力学参数收缩期峰值流速(VS)、舒张末期流速(VD)和阻力指数(RI)值及血清中白细胞介素-13(IL-13)、白细胞介素-18(IL-18)水平。记录两组不良反应情况。结果:观察组总有效率为93.59%高于对照组的83.33%,差异有统计学意义(P<0.05)。治疗后,观察组血清Scr、BUN、iPTH水平及24 hUP低于对照组,eGFR较对照组提高,差异有统计学意义(均P<0.05)。观察组凝血功能、肾脏血流状态优于对照组,差异有统计学意义(均P<0.05)。观察组血清IL-13、IL-18水平均低于对照组,差异有统计学意义(均P<0.05)。观察组不良反应发生率10.26%,对照组不良反应发生率6.41%,比较差异无统计学意义(P>0.05)。结论:贝前列素钠联合前列地尔用于血液透析治疗中疗效显著,可以明显改善患者残余肾功能,降低iPTH、IL-13、IL-18水平,安全性较高。

Objective:To investigate the effects of combination of betaglandin sodium and prostaglandin on renal function and serum levels of whole parathyroid hormone(iPTH),interleukin-13(IL-13),and interleukin-18(IL-18)in hemodialysis patients.Methods:A total of 156 patients with CRF who received hemodialysis were selected as the research objects.The patients were randomly divided into the control group(treated with beprost sodium tablets)of 78 cases,and the observation group(treated with beprost sodium+prostaglandin)of 78 cases.The clinical efficacy of the two groups was evaluated.The serum creatinine(Scr),blood Blood urea nitrogen(BUN),24-hour urine protein quantification(24 hUP)Whole parathyroid hormone(iPTH)level and plasma fibrinogen(Fib),partial thromboplastin time(aPTT),Prothrombin time(PT),D-dimer(D-D)level.Measure the peak systolic velocity(VS),end diastolic velocity(VD),and resistance index(RI)values of renal artery hemodynamic parameters,as well as serum levels of interleukin-13(IL-13)and interleukin-18(IL-18).Record the adverse reactions in both groups.Results:The total effective rate of 93.59%in the observation group was higher than 83.33%in the control group(P<0.05).Compared with the control group,the serum levels of Scr,BUN,iPTH,and 24-hour UP in the observation group decreased,while eGFR decreased(all P<0.05).The improvement of coagulation function and renal blood flow status in the observation group was better than that in the control group(all P<0.05).After treatment,compared with the control group,the serum levels of IL-13 and IL-18 in the observation group decreased(all P<0.05).The incidence of adverse reactions was 10.26%in the observation group and 6.41%in the control group.Conclusion:The combination of betaglandin sodium and alprostadil has a significant therapeutic effect in hemodialysis treatment,which can significantly improve residual renal function in patients,reduce levels of iPTH,IL-13,and IL-18,and have high safety.