CAJ | 학술논문

目的：探讨血液透析联合血液灌流、口服药物碳酸镧治疗方案对尿毒症患者皮肤瘙痒的疗效。方法选择2012年10月至2014年4月武汉市三医院血液净化室尿毒症皮肤瘙痒的患者21例,按照随机数字表法分为血液透析(hemodialysis,HD)联合血液灌流(hemoperfusion,HP)组(A组)11例、血液透析联合血液灌流+口服碳酸镧组(B组)10例。观察并比较2组患者治疗前及治疗后第8周的血肌酐(SCr)、尿素氨(BUN)、血磷水平、甲状旁腺素(PTH)水平及皮肤瘙痒程度。结果2组治疗后,血磷均有下降,差异有统计学意义(P<0.01)；B组较 A组血磷水平显著下降,差异有统计学意义(P<0.01)；2组治疗后,B 组较 A 组的 PTH 水平显著下降,差异有统计学意义(P<0.01)。2组治疗后,原有皮肤瘙痒程度均有改善；其中,A组的治疗有效率(部分缓解3例,完全缓解7例)为63.6%,B组治疗有效率(部分缓解4例,完全缓解5例)为90.0%；B组的治疗有效率较 A 组高,2组比较差异有统计学意义(P<0.01)。结论将新型磷结合剂碳酸镧及 HD联合 HP 应用方法可以更有效的降低尿毒症患者血磷水平、清除引起患者皮肤瘙痒的各种中小分子物质,从而达到缓解尿毒症患者皮肤瘙痒的治疗目的。
목적：탐토혈액투석연합혈액관류、구복약물탄산란치료방안대뇨독증환자피부소양적료효。방법선택2012년10월지2014년4월무한시삼의원혈액정화실뇨독증피부소양적환자21례,안조수궤수자표법분위혈액투석(hemodialysis,HD)연합혈액관류(hemoperfusion,HP)조(A조)11례、혈액투석연합혈액관류+구복탄산란조(B조)10례。관찰병비교2조환자치료전급치료후제8주적혈기항(SCr)、뇨소안(BUN)、혈린수평、갑상방선소(PTH)수평급피부소양정도。결과2조치료후,혈린균유하강,차이유통계학의의(P<0.01)；B조교 A조혈린수평현저하강,차이유통계학의의(P<0.01)；2조치료후,B 조교 A 조적 PTH 수평현저하강,차이유통계학의의(P<0.01)。2조치료후,원유피부소양정도균유개선；기중,A조적치료유효솔(부분완해3례,완전완해7례)위63.6%,B조치료유효솔(부분완해4례,완전완해5례)위90.0%；B조적치료유효솔교 A 조고,2조비교차이유통계학의의(P<0.01)。결론장신형린결합제탄산란급 HD연합 HP 응용방법가이경유효적강저뇨독증환자혈린수평、청제인기환자피부소양적각충중소분자물질,종이체도완해뇨독증환자피부소양적치료목적。
Objective To observe the treatment efficiency of hemodialysis combined with he-moperfusion and oral lanthanum carbonate for uremic pruritus.Methods Twenty-one patients with uremic pruritus attending blood purification room in Wuhan Third Hospital from October 2012 to A-pril 2014 were selected and divided into two groups:A,hemodialysis and hemoperfusion treated group (n=11),and B,hemodialysis,hemoperfusion and oral lanthanum carbonate treated group (n=10). The renal function,blood phosphorus,parathyroid pixel and the extent of skin itch were observed and compared before and 8 weeks after treatment.Statistical tests were used to reveal the differences.Re-sults The blood phosphorus levels in both groups were declined significantly after treatment (P<0.01),more significantly in group B than in group A (P<0.01).After treatment,PTH level in group B was significantly lower than in group A (P<0.01).The symptom of skin itch was signifi-cantly alleviated in both groups after treatment.The remission rate of treatment in group B was 90%, which was significantly higher than 63.6% in group A (P<0.01).Conclusions The combination of new phosphate binder lanthanum carbonate,hemodialysis and hemoperfusion can more effectively re-duce the levels of blood phosphorus and small molecular that can cause skin pruritus,therefore relieve uremic pruritus for therapeutic purposes.