血液透析、血液灌流及奥氮平联合治疗尿毒症脑病的效果

Effect of Hemodialysis,Hemoperfusion and Olanzapine in the Treatment of Uremic Encephalopathy

目的:分析血液透析、血液灌流及口服奥氮平三联方案对尿毒症脑病患者的作用。方法:选取2021年9月—2024年3月贵州省第二人民医院肾内科收治的130例尿毒症脑病患者,采用随机数字表法分为观察组(n=66)与对照组(n=64)。对照组行血液透析联合奥氮平治疗,观察组在对照组基础上增加血液灌流治疗。比较两组阳性和阴性精神症状评定量表(PANSS)评分、生化指标、炎症因子。结果:观察组治疗后PANSS各维度评分均低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后的全段甲状旁腺激素(iPTH)、β_(2)-微球蛋白(β_(2)-MG)水平均低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)均低于对照组,差异均有统计学意义(P<0.05)。结论:在尿毒症脑病的治疗中实施血液透析、血液灌流与奥氮平三联方案可有效减轻炎症反应、清除毒素,改善患者精神症状。

Objective:To analyze the effect of triple regimen of hemodialysis,hemoperfusion and oral Olanzapine in patients with uremic encephalopathy.Method:A total of 130 patients with uremic encephalopathy admitted to Department of Nephrology,the Second People's Hospital of Guizhou Province from September 2021 to March 2024 were selected and divided into observation group(n=66)and control group(n=64)according to random number table method.The control group was treated with hemodialysis combined with Olanzapine,and the observation group was treated with hemoperfusion on the basis of control group.The positive and negative syndrome scale(PANSS)scores,biochemical indexes and inflammatory factors were compared between the two groups.Result:After treatment,the scores of each dimension of PANSS in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The levels of intact parathyroid hormone(iPTH)andβ_(2)-microglobulin(β_(2)-MG)in the observation group after treatment were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,hypersensitive C reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The triple regimen of hemodialysis,hemoperfusion and Olanzapine in the treatment of uremic encephalopathy can effectively reduce inflammatory reaction,remove toxins and improve the mental symptoms of patients.