摘要
目的探讨奥氮平联合血液透析滤过及HA330-Ⅱ血液灌流治疗尿毒症脑病的疗效和安全性。方法选择2015年1月—2019年12月在本院血液净化中心治疗的尿毒症脑病患者82例作为研究对象,随机分为对照组(40例)和实验组(42例)两组。对照组采用血液透析滤过+HA130血液灌流+口服奋乃静治疗;实验组采用血液透析滤过+HA330-II血液灌流+口服奥氮平治疗。观察比较两组患者治疗前后的尿毒症毒素包括Scr及炎症因子等指标变化。用阴性和阳性症状量表(PANSS)进行治疗前后评分,并判断疗效。记录抗精神病药物治疗2周后的相关不良反应。结果治疗后所有患者iPTH、β_(2)MG和炎症因子均较治疗前下降(P<0.05),且实验组低于对照组,差异有统计学意义(P<0.05);治疗后1周,实验组的PANSS评分低于对照组,差异有统计学意义(P<0.05)。实验组总有效39例(92.8%),高于对照组29例(72.5%),差异有统计学意义(P<0.05)。实验组药物不良反应,包括震颤、视力模糊、口干便秘和消化道反应等均低于对照组,差异有统计学意义(P<0.05)。结论奥氮平联合血液透析滤过及HA300-Ⅱ血液灌流治疗尿毒症脑病具有较好临床效果,且不良反应少。
Objective To investigate the efficacy and safety of olanzapine combined with hemodiafiltration and HA330-Ⅱ hemoperfusion in the treatment of uremic encephalopathy.Methods A total of 82 uremic encephalopathy patients those were treated in the blood purification center of the third people's hospital of Yunnan province from January 2015 to December 2019 were selected as study subjects,and they were randomly divided into control group(40 cases)and experimental group(42 cases).The control group was treated with hemodialysis combined with HA130 hemoperfusion and oral administration of perphenazine.The experimental group was treated with hemodialysis combined with HA330-Ⅱ hemoperfusion and oral administration of olanzapine.The changes of uremia toxin including Scr and inflammatory factors before and after treatment in the two groups were observed and compared.The negative and positive symptoms scale(PANSS)was used for scoring before and after treatment,and the efficacy was determined.Adverse events associated with antipsychotic medication after 2 weeks were recorded.Results iPTH,2MG and inflammatory factors decreased in all patients after treatment(P<0.05),and the levels of experimental group were significantly lower than the control group,the differences were statistically significant(P<0.05).One week after treatment,PANSS score of the experimental group was lower than that of the control group,with statistically significant difference(P<0.05).The total effective rate in the experimental group(92.8%,39/40)was higher than that of the control group(72.5%,29/42),the difference was statistically significant(P<0.05).The incidence of adverse drug reactions in the experimental group,including tremor,blurred vision,dry mouth,constipation and digestive tract reactions,were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions Olanzapine combined with hemofiltration and HA300-Ⅱ hemoperfusion in the treatment of uremic encephalopathy has a good clinical effect and with few adverse reactions.
作者
张育安
陈波
吴成云
李晓娜
Zhang Yu’an;Chen Bo;Wu Chengyun;Li Xiaona(Department of nephrology,the third people's hospital of Yunnan,Kunming,Yunnan,650011,China;Department of emergency,the Dian Lake block of Yunnan provincial TCM hospital,Kunming,Yunnan,650021,China)
出处
《齐齐哈尔医学院学报》
2023年第6期525-528,共4页
Journal of Qiqihar Medical University
关键词
尿毒症脑病
血液灌流
奥氮平
奋乃静
Uremic encephalopathy
Blood Hemoperfusion
Olanzapine
Perphenazine
