前列地尔联合肾衰宁片对慢性肾衰竭患者伴血液透析的疗效及对残余肾功能、免疫球蛋白、肺功能血清炎症因子及血液净化指标的影响被引量：40

Effect of Alprostadil combined with Shenshuaining capsule on chronic renal failure patients with hemodialysis and residual renal function,immunoglobulin,serum inflammatory factors and blood purification indexes

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摘要目的探讨前列地尔联合肾衰宁片对慢性肾衰竭(CRF)患者伴血液透析疗效及对残余肾功能、血液净化、免疫球蛋白、肺功能指标、血清炎症细胞因子、氧化应激指标和血清结缔组织生长因子(CTGF)和转化生长因子(TGF)-β1水平的影响。方法CRF患者128例随机分为对照组和观察组,每组64例。患者均给予血液透析、纠正电解质平衡等对症支持治疗;对照组给予肾衰宁片口服,观察组给予肾衰宁和注射用前列地尔治疗。观察两组治疗前后的残余肾功能指标、血液净化指标、免疫球蛋白指标、肺功能指标、血清炎症细胞因子、氧化应激指标和CTGF、TGF-β1水平比较。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后两组血清肌酐(SCr)、血胱抑素(Cys)-C、肾小球滤过率(GFR)、24 h尿蛋白定量、同型半胱氨酸(Hcy)、甲状旁腺激素(PTH)及β2-微球蛋白(MG)、残气量(RV)、白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α、核因子κB抑制蛋白(IκB-α)、丙二醛(MDA)、血清CTGF、TGF-β1水平低于治疗前,免疫球蛋白(Ig)A、IgG、IgM、肺活量(VC)、最大肺活量(FVC)、肺总量(TLC)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平高于治疗前,差异有统计学意义;且治疗后观察组残余肾功能、血液净化指标、免疫球蛋白指标、肺功能指标、血清炎症细胞因子、氧化应激指标和CTGF、TGF-β1水平改善情况优于对照组,差异有统计学意义(P<0.05)。结论前列地尔联合肾衰宁片对慢性肾衰竭患者伴血液透析疗效显著,可以明显改善患者残余肾功能,调节氧化应激水平,降低炎症反应程度,提高免疫功能和肺功能,清除肾脏内的有毒物质,提升血液净化效果,具有较高的有效率和安全性。 Objective To explore the effect of Qianliedier combined with Shenshuaining capsules on the treatment of patients with chronic renal failure(CRF)with hemodialysis and residual renal function indicators,blood purification indicators,immunoglobulin indicators,lung function indicators,serum inflammatory cytokines,oxidative stress indicators and connective tissue growth factor(CTGF),transforming growth factor(TGF)-β1 levels.Methods A total of 128 patients with CRF hospitalized in Tongren People's Hospital from January 2018 to January 2020 were selected.All patients were given symptomatic supportive treatment such as hemodialysis and electrolyte balance correction.The control group was given Shenshuaining capsules for oral administration,and the observation group was given Shenshuaining and alprostadil for injection.The residual renal function indexes,blood purification indexes,immunoglobulin indexes,lung function indexes,serum inflammatory cytokines,oxidative stress indexes and CTGF and TGF-β1 levels of the two groups before and after treatment were observed.Results The total effective rate of the observation group(95.31%)was obviously higher than that of the control group(83.37%).After treatment,serum creatinine(SCr),hemostatin(Cys-C),glomerular filtration rate(GFR),24-hour urine protein quantification,homocysteine(Hcy),parathyroid hormone(PTH)andβ2-microglobulin(MG),residual gas volume(RV),interleukin(IL)-6,IL-8,tumor necrosis factor(TNF)-α,nuclear factorκB inhibition protein(IκB)-α,malondialdehyde(MDA),serum CTGF,TGF-β1 levels were lower than those before treatment,IgA,IgG,IgM,vital capacity(VC),maximum vital capacity(FVC),total lung(TLC),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)levels were higher than those before treatment.After treatment,the improvement of residual renal function,blood purification indexes,immunoglobulin indexes,lung function indexes,serum inflammatory cytokines,oxidative stress indexes and CTGF and TGF-β1 levels in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Alprostadil combined with Shenshuaining capsule has a significant effect on chronic renal failure patients with hemodialysis,which could significantly improve the residual renal function,adjust oxidative stress,reduce the degree of inflammatory response,improve immune function and lung function,and remove the toxic substances in the kidney,improve the blood purification effect with high efficiency and safety.