参附注射液治疗血液透析相关性低血压临床疗效及对血管内皮细胞功能的影响
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R318.16;R544.2

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Clinical Effect of Shenfu Injection for Hemodialysis-Related Hypotension and Its Effect on Vascular Endothelial Cell Function
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    摘要:

    目的:观察参附注射液治疗血液透析相关性低血压临床疗效及对血管内皮细胞功能的影响。方法:将83 例维持性血液透析治疗的血液透析相关性低血压患者分为观察组42 例和对照组41 例。对照组在规律血液透析的基础上给予透析时低血压预防措施、低血压紧急处理措施,观察组在对照组的基础上于每次透析结束后静脉注射参附注射液。2 组疗程均为3 个月,比较2 组透析前动脉压基础值与透析期间监测的平均动脉压最低值之间的差值,统计2 组治疗后透析时低血压平均发生例数;比较2 组治疗前后的未完成超滤量、尿素清除指数(Kt/V);比较2 组治疗前后血清内皮素-1(ET-1)、血管内皮生长因子(VEGF)含量;比较2 组临床疗效。结果:经秩和检验,观察组疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,观察组动脉压最大差值明显低于对照组(P<0.05),观察组低血压发生例数明显低于对照组(P<0.05)。治疗前,2 组未完成超滤量和Kt/V 比较,差异无统计学意义(P>0.05);治疗后,2 组未完成超滤量均较治疗前降低(P<0.05),Kt/V 较治疗前升高(P<0.05);且观察组2 项指标改善较对照组更显著(P<0.05)。治疗前,2 组ET-1、VEGF 含量比较,差异无统计学意义(P>0.05)。治疗后,2 组ET-1、VEGF 含量均较治疗前降低(P<0.05),且观察组ET-1、VEGF 含量低于对照组(P<0.05)。结论:参附注射液可减少患者血液透析时发生低血压次数,维持透析时的血压稳定,提高血液透析的充分性,同时可改善血管内皮功能。

    Abstract:

    Abstract: Objective: To observe the clinical effect of Shenfu injection for hemodialysis- related hypotension and its effect on vascular endothelial cell function. Methods:A total of 83 cases of patients with hemodialysis-related hypotension undergoing maintenance hemodialysis were divided into the observation group and the control group, 42 and 41 cases in each group respectively. The control group was given hypotension prevention measures and hypotension emergency treatment measures on the basis of regular hemodialysis,and the observation group was additionally given Shenfu injection after each dialysis based on the treatment of the control group. Both groups were treated for three months. Before dialysis, the difference between the baseline value of arterial pressure before dialysis and the lowest value of mean arterial pressure monitored during dialysis was compared between the two groups. After treatment, the average incidence of hypotension during dialysis in the two groups was counted. Before and after treatment, the uncompleted ultrafiltration volume, blood cleared of urea(Kt/V) and the contents of endothelin-1(ET-1) and vascular endothelial growth factor(VEGF) in serum in the two groups were compared. The clinical effect was compared in two groups. Results: There was significant difference being found in the comparison of the clinical effect between the two groups(P<0.05), and the curative effect in the observation group was better than that in the control group. The maximum difference of arterial pressure in the observation group was significantly lower than that in the control group(P<0.05). The incidence of hypotension in the observation group was significantly lower than that in the control group(P<0.05). After treatment, the uncompleted ultrafiltration volume in the observation group was significantly lower than that in the control group(P<0.05),and Kt/V was significantly higher(P<0.05). Before treatment, there was no significant difference being found in the comparison of uncompleted ultrafiltration volume and blood cleared of urea between the two groups(P>0.05). After treatment, the uncompleted ultrafiltration volume was decreased when compared with that before treatment(P<0.05), and blood cleared of urea was increased(P<0.05); the improvement of the above two indexes in the observation group was more significant than that in the control group(P<0.05). Before treatment, there was no significant difference being found in the comparison of the contents of ET- 1 and VEGF between the two groups(P<0.05). After treatment,the contents of ET-1 and VEGF in the two groups were decreased when compared with those before treatment(P<0.05), and the contents in the observation group were fewer than those in the control group(P<0.05). Conclusion:Shenfu injection can reduce the frequency of hypotension during hemodialysis,maintain stable blood pressure during dialysis,improve the adequacy of hemodialysis,and improve vascular endothelial function.

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赵大奎,陈红艳.参附注射液治疗血液透析相关性低血压临床疗效及对血管内皮细胞功能的影响[J].新中医,2021,53(18):72-75

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  • 在线发布日期: 2021-09-24
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