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连续性血液净化联合血液灌流对糖尿病肾病合并难治性心衰的治疗效果分析
引用本文:王海生,吴锋,李文冬,张进,温洁,刘华.连续性血液净化联合血液灌流对糖尿病肾病合并难治性心衰的治疗效果分析[J].现代生物医学进展,2016,16(22):4298-4301.
作者姓名:王海生  吴锋  李文冬  张进  温洁  刘华
作者单位:宝鸡市人民医院肾病内科;西安交通大学医学院第一附属医院血液净化科
基金项目:陕西省自然科学基金项目(2013JM4012)
摘    要:目的:研究连续性血液净化联合血液灌流技术治疗糖尿病肾病合并难治性心衰患者的临床效果。方法:选择我院收治的60例糖尿病肾病合并难治性心衰患者为研究对象,按入院先后顺序随机分为对照组和观察组,每组各30例患者,对照组患者给予常规对症治疗,而观察组患者在常规对症治疗的基础上应用连续性血液净化联合血液灌流技术,比较两组患者的肾、心功能变化和治疗效果。结果:治疗后,观察组的总有效率、好转率及1年存活率均明显高于对照组(P0.05)。对照组患者的肾、心功能指标均较治疗前显著改善(除Scr、E/A),而观察组的各项肾、心功能指标均较治疗前明显改善,且均明显优于对照组,差异均具有统计学意义(P0.05)。结论:连续性血液净化联合血液灌流技术治疗糖尿病肾病合并难治性心衰较常规药物对症治疗更有效。

关 键 词:连续性血液净化  血液灌流  糖尿病肾病  难治性心衰

Analysis on the Effect of Continuous Blood Purification Combined with Hemoperfusion on Diabetic Nephropathy Patients Complicated with Refractory Heart Failure
Abstract:Objective:To study the clinical effect of continuous blood purification (CBP) combined with hemoperfusion (HP) on diabetic nephropathy (DN) patients complicated with refractory heart failure (RHF).Methods:60 cases of diabetic nephropathy complicated with refractory heart failure were selected as the research objects. They were randomly divided into the control group and the study group according to the order of hospitalization. There were 30 cases in each group. The control group received conventional symptomatic treatment, while on the basis of conventional symptomatic treatment, the study group received CBP combined with HP technique. The changes of renal and cardiac function in both groups were compared.Results:After treatment, the total effective rate, improvement rate and the 1-year survival rate of the study group were significantly higher than those of the control group (P<0.05). The renal and cardiac function indexes of the control group were significantly improved than before treatment (except Scr and E/A). While each renal and cardiac function index of the study group were significantly improved than before treatment, and were significantly better than those of the control group, the difference was statistically significant (P<0.05).Conclusion:CBP combined with HP was more effective than conventional drugs symptomatic treatment in the treatment of DN complicated with RHF.
Keywords:Continuous blood purification  Hemoperfusion  Diabetic nephropathy  Refractory heart failure
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