血液透析联合rHu EPO在尿毒症中的应用

Application of hemodialysis combined with rHu EPO in uremia

目的 探索血液透析联合重组人类促红细胞生长素(rHu EPO)在尿毒症患者中的应用,以及对其血清超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)及血浆白蛋白(Alb)水平的影响。方法 选取2020年1月-2022年2月于淮北矿工总医院血液净化中心就诊的84例尿毒症患者,按照治疗方法不同分为对照组和观察组,每组42例,对照组采用血液透析治疗,观察组在对照组的基础上联合rHu EPO进行治疗。比较两组患者hs-CRP、Hb、Alb、血清铁蛋白(SF)、铁转蛋白饱和度(TS)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平以及治疗有效率和并发症发生情况。结果 治疗前,两组患者Hb、Alb、SF、TS、hs-CRP、CRP、IL-6、TNF-α水平比较,差异均无统计学意义(P均>0.05)。治疗后,两组患者Hb、Alb、SF、TS水平明显升高,且观察组Hb、Alb、SF、TS水平明显高于对照组,差异均有统计学意义(t=11.339、2.025、31.209、8.963,P均<0.05);两组患者hs-CRP、CRP、IL-6、TNF-α水平明显下降,且观察组hs-CRP、CRP、IL-6、TNF-α水平明显低于对照组,差异均有统计学意义(t=7.028、3.243、2.897、2.120,P均<0.05)。观察组治疗总有效率为90.48%,明显高于对照组的66.67%,差异有统计学意义(χ^(2)=7.071,P<0.05)。且观察组的皮肤瘙痒、食欲不振、睡眠障碍、骨痛发生率(11.90%、19.05%、9.52%、4.76%)明显低于对照组(40.48%、47.62%、30.95%、23.81%),差异均有统计学意义(χ^(2)=8.868、7.714、5.974、6.222,P均<0.05)。结论 血液透析联合rHu EPO治疗尿毒症患者能够明显改善患者的炎性反应,改善贫血症状,具有一定的临床使用价值。

Objective To explore the application of hemodialysis combined with recombinant human erythrocyte growth factor(rHu EPO)in uremia patients,and the influence on the levels of serum hypersensitive C-reactive protein(hs-CRP),hemoglobin(Hb)and plasma albumin(Alb).Methods From January 2020 to February 2022,84 patients with uremia who were treated in the Blood Purification Center of Huaibei Miners General Hospital were selected and divided into control group and observation group according to the different treatment methods,with 42 patients in each group.The control group was treated with hemodialysis,and the observation group was treated with rHu EPO on the basis of the control group.The levels of hs-CRP,Hb,Alb,serum ferritin(SF),ferritin saturation(TS),C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),treatment effectiveness and complications between the two groups were compared.Results There were no significant differences in the levels of Hb,Alb,SF,TS,hs-CRP,CRP,IL-6 and TNF-α between the two groups before treatment(all P>0.05).After treatment,the levels of Hb,Alb,SF and TS in the two groups were significantly increased,and the levels of Hb,Alb,SF and TS in the observation group were obviously higher than those in the control group,the differences were statistically significant(t=11.339,2.025,31.209,8.963;all P<0.05);the levels of hs-CRP,CRP,IL-6 and TNF-α were obviously decreased in both groups,and the levels of hs-CRP,CRP,IL-6 and TNF-α in the observation group were obviously lower than those in the control group,the differences were statistically significant(t=7.028,3.243,2.897,2.120;all P<0.05).The total effective rate of the observation group was 90.48%,which was obviously higher than that of the control group(66.67%),the differences were statistically significant(χ^(2)=7.071,P<0.05).The incidence of pruritus,loss of appetite,sleep disorder and bone pain in the observation group(11.90%,19.05%,9.52%,4.76%)were obviously lower than those in the control group(40.48%,47.62%,30.95%,23.81%),and the differences were statistically significant (χ^(2)=8.868,7.714,5.974,6.222;all P<0.05).Conclusion Hemodialysis combined with rHu EPO could significantly improve the inflammatory reaction and anemia symptoms of uremic patients,which had certain clinical value.