尿毒清颗粒联合维持性血液透析对慢性肾衰竭患者肾功能及血清泌乳素、CYFRA21-1的影响

Effect of Niaoduqing Granules combined with maintenance hemodialysis on kidney function and serum prolactin and CYFRA21-1 in patients with chronic renal failure

目的:探究尿毒清颗粒联合维持性血液透析治疗对慢性肾衰竭(CRF)患者肾功能及血清泌乳素(PRL)、细胞角蛋白19片段(CYFRA21-1)的影响。方法:选取104例CRF患者为研究对象,按照不同治疗方法将维持性血液透析治疗为对照组(n=52);给予尿毒清颗粒联合维持性血液透析治疗为试验组(n=52),两组均持续治疗6个月。比较两组患者临床疗效、肾功能[尿素氮(BUN)、肌酐(Scr)、肌酐清除率(Ccr)]、24 h尿量、钙磷代谢(血钙、血磷)、炎症因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素6(IL-6)]、PRL、CYFRA21-1、血清T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及不良反应发生情况。结果:透析前,两组患者BUN、Scr、Ccr、24 h尿量、血钙、血磷、TNF-α、CRP、IL-6、PRL、CYFRA21-1、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较,差异均无统计学意义(P>0.05)。治疗后,试验组患者治疗总有效率高于对照组(P<0.05)。与透析前比较,两组患者BUN、Scr、24 h尿量、TNF-α、CRP、IL-6、PRL、CYFRA21-1、CD8^(+)均降低(P<0.05),且试验组低于对照组;Ccr、CD4^(+)、CD4^(+)/CD8^(+)均升高(P<0.05),且试验组高于对照组(P<0.05)。试验组不良反应率低于对照组(P<0.05);两组血磷、血钙比较均无统计学差异(P>0.05)。结论:尿毒清颗粒联合维持性血液透析治疗可改善慢性肾衰竭患者肾功能,同时降低炎性因子和血清PRL、CYFRA21-1水平,提高免疫功能,且安全性较高。

Objective:To investigate the effect of Niaoduqing Granules combined with maintenance hemodialysis on kidney function and serum prolactin(PRL)and cytokeratin 19 fragment(CYFRA21-1)in patients with chronic renal failure(CRF).Methods:104 patients with CRF were divided according to different treatment methods.52 patients treated with maintenance hemodialysis were included in the control group,and the other 52 patients treated with Niaoduqing Granules combined with maintenance hemodialysis were included in the treatment group.All patients were treated for 6 months.The clinical efficacy,kidney function[blood urea nitrogen(BUN),serum creatinine(Scr)and creatinine clearance(Ccr)],24 h urine volume,calcium-phosphorus metabolism(blood calcium and blood phosphorus),inflammatory factors[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)],PRL,CYFRA21-1,serum T lymphocyte subsets(CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)),and the incidence of adverse reactions were compared between the two groups.Results:There were no significant differences in BUN,Scr,Ccr,24 h urine volume,blood calcium,blood phosphorus,TNF-α,CRP,IL-6,PRL,CYFRA21-1,CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)levels between the two groups before dialysis(P>0.05).After treatment,the total effective rate in the treatment group was higher than that in the control group(P<0.05).Compared with pre-dialysis,BUN,Scr,24 h urine volume,TNF-α,CRP,IL-6,PRL,CYFRA21-1 and CD8^(+)in the two groups decreased(P<0.05),and the treatment group was lower than the control group(P<0.05).Ccr,CD4^(+)and CD4^(+)/CD8^(+)increased(P<0.05),and the treatment group was higher than the control group(P<0.05).The incidence of adverse reactions in the treatment group was lower than that in the control group(P<0.05).There was no significant difference in blood phosphorus or blood calcium between the two groups(P>0.05).Conclusion:Niaoduqing Granules combined with maintenance hemodialysis can improve kidney function in patients with CRF,reduce inflammatory factors and serum PRL and CYFRA21-1 levels,and improve immune function,with high safety.