CAJ | 학술논문

目的探讨血液透析和血液灌流联合治疗维持性血液透析尿毒症患者皮肤瘙痒的疗效.方法将81例尿毒症皮肤瘙痒患者按皮肤瘙痒程度分为3组,每组按随机数字表法分为治疗组和对照组.治疗组和对照组采用营养支持及综合治疗,对照组在此基础上加用血液透析治疗;治疗组采用血液灌流+血液透析治疗.于治疗前、治疗3、6周后分别检测两组患者甲状旁腺激素、β2微球蛋白的水平变化以及皮肤瘙痒程度并进行比较.结果治疗组患者经治疗后3、6周后甲状旁腺激素和β2微球蛋白水平与对照组比较差异有统计学意义(P＜0.05);治疗组患者经治疗3周后皮肤瘙痒症状较对照组改善,其中可视模拟评分法评为6～8分组改善最明显(P＜0.05).治疗组治疗6周后皮肤瘙痒症状较对照组改善,其中可视模拟评分法评分＞6分组改善最明显(P＜0.05).结论血液灌流+血液透析联合治疗能显著降低尿毒症患者甲状旁腺激索和β2微球蛋白水平,减轻皮肤瘙痒症状.
목적 탐토혈액투석화혈액관류연합치료유지성혈액투석뇨독증환자피부소양적료효.방법 장81례뇨독증피부소양환자안피부소양정도분위3조,매조안수궤수자표법분위치료조화대조조.치료조화대조조채용영양지지급종합치료,대조조재차기출상가용혈액투석치료;치료조채용혈액관류+혈액투석치료.우치료전、치료3、6주후분별검측량조환자갑상방선격소、β2미구단백적수평변화이급피부소양정도병진행비교.결과 치료조환자경치료후3、6주후갑상방선격소화β2미구단백수평여대조조비교차이유통계학의의(P＜0.05);치료조환자경치료3주후피부소양증상교대조조개선,기중가시모의평분법평위6～8분조개선최명현(P＜0.05).치료조치료6주후피부소양증상교대조조개선,기중가시모의평분법평분＞6분조개선최명현(P＜0.05).결론 혈액관류+혈액투석연합치료능현저강저뇨독증환자갑상방선격색화β2미구단백수평,감경피부소양증상.
Objective To explore the clinical efficacy of maintenance hemodialysis (HD) combined with hemoperfusion( HP) in treatment of uremic pruritis. Methods The 81 uremic patients with uremic pruritus were divided into 3 groups according to degree of skin itching. Each group was randomly divided into treatment group and control group. On the basis of nutrition support and comprehensive treatment, patients in treatment group were treated with combined HD + HP, while the patients in control group received HD treatment only. Parathyroid hormone (PTH), β2 microglobulin (β2-MG) levels and the degree of pruritus in patients were measured before treatment, treatment for 3 weeks and 6 weeks after in each group. Results effects were evaluated by comparing the PTH, β2 microglobulin (β2-MG) levels and the degree of pruritus of the experimental groups and control groups. Results 3 weeks and 6 weeks after treatment, the PTH and β2-MG levels in the experimental groups were markedly decreased (P ＜ 0.05). After 3 weeks treatment, compared with the control group the pruritus symptoms improved in the treatment group, and the visual analogue scales (VAS) score 6-8 group improved most significantly (P ＜ 0.05). After 6 weeks treatment, compared with the control group the pruritus symptoms improved in the treatment group, and the VAS score ＞ 6 group improved most significantly (P ＜ 0.05).Conclusion HP + HD combination therapy can significantly reduce PTH, β2-MG levels and skin itching in uremic patients.