小剂量激素联合血液透析治疗尿毒症的临床疗效分析.docVIP

小剂量激素联合血液透析治疗尿毒症的临床疗效分析 　　[摘要] 目的 探讨小剂量激素联合血液透析治疗尿毒症的疗效及其临床应用价值研究。方法 回顾性研究本院40例尿毒症患者，随机分为两组，每组20例。对照组接受单纯的血液透析治疗，观察组在对照组的基础上联合小剂量泼尼松或甲泼尼龙治疗，比较两组患者术后疗效以及手术前后血浆中的内毒素、晚期氧化蛋白产物、甲状旁腺激素、肝酶、心肌酶、肾功能等指标的变化。结果 观察组和对照组第1年的生存率无显著差异，但是观察组第3年、第5年的生存率显著高于对照组（P0.05）。两组患者治疗前的内毒素、晚期氧化蛋白产物、甲状旁腺激素等水平无明显差异，但观察组治疗后以上指标均得到显著改善（P0.05）。结论 小剂量激素联合血液透析治疗尿毒症可显著改善尿毒症患者的症状，近期疗效显著，提高患者生活质量，降低不良反应，值得在临床推广应用。 　　[关键词] 小剂量激素；血液透析；尿毒症 　　[中图分类号] R692.5 [文献标识码] B [文章编号] 1673-9701（2014）27-0135-03 　　[Abstract] Objective To explore the efficiency of small-dose hormone and hematodialysis in the treatment of uremia and its clinical application value. Methods Forty patients with uremia in our hospital were randomly divided into two groups，20 cases in each group. The control group was treated with simple hematodialysis， while the observation group was added small-dose prednisone or methylprednisolone based on the control group. The postoperative efficiency and changes of plasma endotoxin，advanced oxidation protein products， parathyroid hormone， hepatic enzyme， myocardial？enzyme and renal function before and after operation were compared in two groups. Results There was no significant difference between observation group and control group in terms of the first-year survival rate，whereas the third and fifth-year survival rates in observation group were markedly higher than in control group（P0.05）. There were no obvious differences between two groups regarding the preoperative levels of endotoxin， advanced oxidation protein products and parathyroid hormone， but the above indexes in observation group after treatment were improved notably（P0.05）. Conclusion Small-dose hormone combined with hematodialysis can markedly ameliorate the symptoms of patients with uremia， have significant short-term effects， improve the quality of life and decrease adverse reactions， being worthy of clinical popularization and application. 　　[Key words] Small-dose hormone； Hemodialysis； Uremia 　　慢性肾病是目前较为常见的非传染性慢性病，临床治疗此类患者较为棘手，