目的 观察生血宁片联合促红细胞生成素治疗维持性血液透析患者肾性贫血的疗效.方法 选取2015年1月至2016年1月合肥市第五人民医院血液净化中心维持性血液透析肾性贫血患者40例,采用随机对照方法将该40例患者随机分为两组,每组20例.两组患者均使用促红细胞生成素治疗,治疗组在此基础上加用生血宁,疗程3个月. 疗程结束后检测两组患者血红蛋白浓度(Hb)、红细胞压积水平(Hct)、 血清铁蛋白(SF) 及转铁蛋白饱和度(TSAT).结果 3个月后与治疗前相比,对照组的血清Hb(92.47±3.88)g/L、Hct(24.18±4.46)%、SF(165.2±31.68) μg/L、TAST(24.28±5.13)%均较治疗前升高,差异均有统计学意义(P<0.05);治疗组的血清Hb(115.8±±4.46) g/L、Hct(31.24±7.86)%、SF(189.2±46.68) μg/L、TAST(31.24±8.24)%均较治疗前升高,差异均有统计学意义(P<0.05);且治疗组均优于对照组,差异均有统计学意义(P<0.05).治疗组总有效率为85.0%,高于对照组 65.0%,差异有统计学意义(P<0.05).结论 生血宁片联合促红细胞生成素治疗维持性血液透析患者肾性贫血效果更优.
目的观察不同钙浓度(1.25、1.50、1.75mmol/L)透析液治疗3个月对患者血压、钙、磷、甲状旁腺激素的影响。方法维持性血液透析病人45例,分为三组治疗3个月:A组接受1.25mmol/L透析液治疗;B组接受1.50mmol/L透析液治疗;C组接受1.75mmol/L透析液治疗。比较三组患者使用不同钙浓度透析液监测透析前后血压,透析前后血清钙、磷,应用放射免疫法测定血清全段IPTH水平。结果使用钙浓度1.75mmol/L透析液血压升高(P<0.01),血钙浓度升高(P<0.05),IPTH下降(P<0.01);使用钙浓度1.50mmol/L透析液血压、血钙浓度、IPTH无明显变化;使用钙浓度1.25mmol/L透析液血压降低(P<0.01),血钙浓度降低(P<0.01),IPTH上升(P<0.01)。结论低钙透析液会降低患者血压、血钙、IPTH升高;高钙透析液会升高血压、血钙、IPTH下降。
Objective To explore the changes of peripheral blood endothelial progenitor cells(EPCs)and high-sensitive-C-reactive protein(hs-CRP)levels and its correlation in patients with acute brain stroke.Methods A total of 58 patients with acute brain stroke(46 cases of cerebral infarction,cerebral hemorrhage in 12 cases),22 health cases(control group)were chosed as the research object.Patients' clinical history data such as age,gender,height,waist circumference values,smoking history,family history of coronary heart disease,cerebrovascular disease,kidney disease,hypertension,and diabetes were collected.And recorded the blood pressure(BP),heart rate(HR),blood sugar,creatinine(Cr),usea nitrogen(BUN).The peripheral venous blood samples were collected at 1,7,14,21 days after stroke,EPCs marked with CD133-PE,KDR-APC fluorescent antibody were detected,CD133 / KDR positive cells were counted through flow cytometry,and hs-CRP levels were detected by immune transmission turbidimetry.At the same time,high-density lipoprotein cholesterol(HDL),low density lipoprotein cholesterol(LDL),triglyceride(TG),total cholesterol(TC),and other cardiovascular risk factors were tested by fully automatic biochemical analyzer.Biochemical parameters between each group were tested by t-test and one-way ANOVA test,the relationship between quantity of EPCs and cardiovascular risk factors were analyzed by one-way ANOVA.Results The quantity of peripheral blood EPCs of acute brain stroke patients is significantly reduced compare with control group(t=2.65 ~ 3.20,P<0.01),EPCs quantity decreased at 7-14 days after onset and recovered at 14-21 days.Correlation analysis showed that peripheral blood EPCs quantity of acute brain stroke patients was negatively correlated with hs-CRP(r=0.423),and negatively correlated with cerebrovascular disease risk factors(smoking history,history of hypertension,systolic blood pressure,TC,TG,r=-0.424 ~-0.278,P<0.05).Conclusion EPCs quantity can be used as marker of damage and repair in acute stroke,and also as a evaluation index of clinical risk factors.
