维持性血液透析尿毒症患者Ret、MCV、MCHC、铁代谢指标与肾性贫血的关系研究

Study on the relationship between Ret, MCV, MCHC, iron metabolism indicators and renal anemia in maintenance hemodialysis patients with uremia

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目的:分析尿毒症维持性血液透析(MHD)患者红细胞相关指标、铁代谢指标水平及其同肾性贫血的关系。方法:选取我院2024年10月-2025年10月期间尿毒症MHD患者70例为研究对象,依照其是否发生肾性贫血分为贫血组(49例)、无贫血组(21例),对比两组患者红细胞相关指标以及等铁代谢指标,同时对比不同贫血严重程度患者各项指标水平差异,并分析尿毒症MHD患者肾性贫血的相关影响因素。结果:贫血组、无贫血组患者红细胞血红蛋白浓度(MCHC)、总铁结合力(TIBC)水平无较大差异(P>0.05),贫血组患者网织红细胞计数(Ret)、血清铁蛋白(SF)、转铁蛋白(TRSF)水平低于无贫血组、平均红细胞体积(MCV)水平高于无贫血组(P<0.05);轻度组、中度组、重度组患者Ret、MCV、SF、TRSF差异显著(P>0.05);不同贫血严重程度患者MCHC、TIBC水平比较,差异无统计学意义(P>0.05);多因素Logistic回归结果显示,Ret(OR=0.2063)、MCV(OR=4.152)、SF(OR=0.341)、TRSF(OR=0.281)是尿毒症MHD患者发生肾性贫血的重要影响因素(P<0.05)。结论:尿毒症MHD患者存在较高的肾性贫血风险,且不同贫血程度患者的Ret、MCV及SF、TRSF等指标水平存在差异性,亦是患者发生肾性贫血的重要影响因素。
Objective: To analyze the levels of red blood cell related indicators, iron metabolism indicators and their relationship with renal anemia in uremic patients with maintenance hemodialysis (MHD). Methods: 70 cases of uremic MHD patients in our hospital from October 2024 to October 2025 were selected as the research object, and were divided into anemia group (49 cases) and non anemia group (21 cases) according to whether renal anemia occurred. The red blood cell related indexes and iron metabolism indexes of the two groups were compared, and the differences of various indexes in patients with different anemia severity were compared, and the related influencing factors of renal anemia in uremic MHD patients were analyzed. Results: there was no significant difference in the levels of erythrocyte hemoglobin concentration (MCHC) and total iron binding capacity (TIBC) between anemia group and non anemia group (P>0.05). The levels of reticulocyte count (RET), serum ferritin (SF), transferrin (trsf) in anemia group we

维持性血液透析尿毒症患者Ret、MCV、MCHC、铁代谢指标与肾性贫血的关系研究

Study on the relationship between Ret, MCV, MCHC, iron metabolism indicators and renal anemia in maintenance hemodialysis patients with uremia

:-
 
目的:分析尿毒症维持性血液透析(MHD)患者红细胞相关指标、铁代谢指标水平及其同肾性贫血的关系。方法:选取我院2024年10月-2025年10月期间尿毒症MHD患者70例为研究对象,依照其是否发生肾性贫血分为贫血组(49例)、无贫血组(21例),对比两组患者红细胞相关指标以及等铁代谢指标,同时对比不同贫血严重程度患者各项指标水平差异,并分析尿毒症MHD患者肾性贫血的相关影响因素。结果:贫血组、无贫血组患者红细胞血红蛋白浓度(MCHC)、总铁结合力(TIBC)水平无较大差异(P>0.05),贫血组患者网织红细胞计数(Ret)、血清铁蛋白(SF)、转铁蛋白(TRSF)水平低于无贫血组、平均红细胞体积(MCV)水平高于无贫血组(P<0.05);轻度组、中度组、重度组患者Ret、MCV、SF、TRSF差异显著(P>0.05);不同贫血严重程度患者MCHC、TIBC水平比较,差异无统计学意义(P>0.05);多因素Logistic回归结果显示,Ret(OR=0.2063)、MCV(OR=4.152)、SF(OR=0.341)、TRSF(OR=0.281)是尿毒症MHD患者发生肾性贫血的重要影响因素(P<0.05)。结论:尿毒症MHD患者存在较高的肾性贫血风险,且不同贫血程度患者的Ret、MCV及SF、TRSF等指标水平存在差异性,亦是患者发生肾性贫血的重要影响因素。
To analyze the levels of red blood cell related indicators, iron metabolism indicators and their relationship with renal anemia in uremic patients with maintenance hemodialysis (MHD). Methods: 70 cases of uremic MHD patients in our hospital from October 2024 to October 2025 were selected as the research object, and were divided into anemia group (49 cases) and non anemia group (21 cases) according to whether renal anemia occurred. The red blood cell related indexes and iron metabolism indexes of the two groups were compared, and the differences of various indexes in patients with different anemia severity were compared, and the related influencing factors of renal anemia in uremic MHD patients were analyzed. Results: there was no significant difference in the levels of erythrocyte hemoglobin concentration (MCHC) and total iron binding capacity (TIBC) between anemia group and non anemia group (P>0.05). The levels of reticulocyte count (RET), serum ferritin (SF), transferrin (trsf) in anemia group were lower than those in non anemia group, and the level of mean corpuscular volume (MCV) was higher than that in non anemia group (P<0.05); There were significant differences in RET, MCV, SF and trsf among mild group, moderate group and severe group (P>0.05); There was no significant difference in MCHC and TIBC levels among patients with different anemia severity (P>0.05); Multivariate logistic regression results showed that RET (or=0.2063), MCV (or=4.152), SF (or=0.341), trsf (or=0.281) were important influencing factors of renal anemia in uremic MHD patients (P<0.05).Conclusion: Uremic MHD patients have a higher risk of renal anemia, and there are differences in the levels of Ret, MCV, SF, TRSF and other indicators among patients with different degrees of anemia, which are also important influencing factors for the occurrence of renal anemia in patients.
论著

基于“固肾泄浊”理法方药辨治慢性肾衰竭的应用

Prescription of chronic renal failure based on the theory of “reinforcing the kidney and reducing turbidity”

:293-298
 
       慢性肾衰竭(CRF)核心病机为脾肾两虚、湿浊瘀毒互结,形成“精亏-络损-浊毒”的恶性循环。文章基于“肾藏精泄浊”理论,系统阐释固肾泄浊法论治CRF的理论依据及临床实践经验。固肾泄浊法以“固肾培本,分消浊毒”为纲,通过填精固摄恢复脾肾气化枢纽,通络活血改善肾络瘀阻,并分消三焦湿浊、瘀浊、毒浊,打破“精微漏泄-浊毒蓄积—络脉损伤”病理过程。唐阁主任基于此创立固肾泄浊方,临床观察表明该方治疗CRF患者疗效确切。固肾泄浊方组方注重脾肾互根、寒温相济、升降相因,动态调整固肾与泄浊权重,契合CRF不同分期病机演变。固肾泄浊法融合藏象学说、络病理论及三焦气化论,以“补泻兼施、藏泄并调”实现标本同治,为CRF中医药治疗提供新思路。
       The core pathological mechanism of chronic renal failure(CRF)involves deficiency of the spleen and kidney,intertwined with dampness,turbidity,blood stasis and toxins,forming a vicious cycle of “essence deficiency-collateral damage-turbid toxin accumulation” Based on the theory of “The kidney stores essence and reduces turbidity”,this article systematically elucidates the theoretical foundation and clinical application of  reinforcing the kidney and  reducing turbidity method for treating CRF.This method,guided by the principles of “securing the kidney to strengthen the root,and resolving turbid toxins”,aims to replenish essence and consolidate the kidney to restore the pivotal qi transformation functions of the spleen and kidney,to unblock collaterals and circulate blood to ameliorate renal collateral stasis,to resolve damp-turbidity,stasis-turbidity,and toxin-turbidity from the Sanjiao.This strategy breaks the pathological progression of “leakage of essence-accumulation of turbid toxins-damage to collaterals”.Professor Tang Ge formulate this Reinforcing the Kidney and Reducing Turbidity Formula(固肾泄浊方,Gushen Xiezhuo Fang)based on this approach.Clinical observations confirmed its significant efficacy in CRF patients.The formula focuses on the interdependence of the spleen and kidney,balance of warm and cool properties,and harmony of ascending and descending actions.It dynamically adjusts the therapeutic focus between kidney-securing and turbidity-reducing to align with the evolving pathogenesis across different CRF stages.Integrating theories of visceral manifestation(Zangxiang),collateral disease,and Sanjiao qi transformation,reinforcing the kidney and  reducing turbidity method achieves simultaneous treatment of  root and branch through “simultaneous supplementation and drainage,concurrent storing and discharging”.This approach offers a novel perspective for the traditional Chinese medicine treatment of CRF.
论著

LAMP3 基因表达与肾癌之间的因果关系:一项基于孟德尔随机化分析的研究

Causal relationship between LAMP3 gene expression and renal cancer:A Mendelian randomization analysis

:88-94
 
       目的   探讨溶酶体相关膜蛋白3(LAMP3)与肾癌发病风险之间的因果关系,为肾癌的分子致病机制提供新的理论依据。方法   基于全基因组关联研究(GWAS)数据,采用孟德尔随机化分析方法,评估LAMP3基因表达与肾癌的因果关系。并通过GEPIA2分析LAMP3表达对肾癌总体生存期(OS)及无病生存期(DFS)的关系。结果  LAMP3基因变异与肾癌风险呈正相关,提示LAMP3的表达可能增加肾癌的发病风险。此外,GEPIA2分析进一步显示,LAMP3的高表达与肾癌患者的低总体生存期(OS)及无病生存期(DFS)显著相关。结论   本研究通过孟德尔随机化分析探讨了LAMP3基因表达与肾癌的因果关系,结果表明LAMP3可能是肾癌的潜在致病因子,并与肾癌预后相关。这为肾癌的分子致病机制研究提供了重要的理论依据,并为未来的生物标志物和靶向治疗策略的开发提供了新的思路。
        Objective  To investigate the causal  relationship  between LAMP3 expression and  renal cancer  risk  using Mendelian randomization analysis,providing a theoretical basis for understanding the molecular mechanisms underlying renal cancer.Methods  This study utilized data from genome-wide association studies(GWAS)and employed Mendelian randomization analysis to assess the causal relationship between LAMP3 gene expression and renal cancer.Additionally,GEPIA2 was used to examine the association between LAMP3 expression and overall survival(OS)and disease-free survival(DFS)in renal cancer patients.Results  Variants in the LAMP3 gene were positively correlated with renal cancer risk,suggesting that LAMP3 expression may increase the likelihood of developing renal cancer.Furthermore,GEPIA2 analysis  revealed that high expression of LAMP3 was significantly associated with lower OS and DFS in renal cancer patients.Conclusions  This study explored the causal  relationship between LAMP3 gene expression and renal cancer through Mendelian randomization analysis.The results indicate that LAMP3 may be a potential pathogenic factor in renal cancer and is associated with poor prognosis.These findings provide important theoretical insights into the molecular mechanisms of  renal cancer and offer new perspectives for the development of biomarkers and targeted therapeutic strategies in the future.
论著

基于 RoSCo 评分系统的早期下床活动时机在肾肿瘤患者术后的应用

Application of early mobilization timing based on RoSCo scoring system in postoperative renal tumor patients

:1656-1662
 
       目的   探讨基于手术风险模型(RoSCo)评分系统的早期下床活动时机在肾肿瘤患者术后的应用效果。方法   选取2021年6月—2024年6月天津市人民医院收治的80例肾肿瘤患者,应用随机数字表法将其分为观察组与对照组,各40例。80例患者均实施腹腔镜肾部分切除术,对照组实施常规干预与术后早期下床活动干预,观察组实施常规干预与基于RoSCo评分系统的早期下床活动时机干预。对比两组术后康复水平,疼痛程度与睡眠质量,并发症发生率及生活质量。结果   观察组首次下床活动(19.30±4.17)h、排气(22.03±4.15)h、排便时间(29.93±5.58)h及术后住院时间(5.35±1.33)h短于对照组[(25.08±5.11)、(29.38±5.75)(34.20±5.98)(7.35±2.38)]h,对比差异有统计学意义(t=-5.540、-6.557、-3.308、-4.637,P<0.05);手术后,观察组视觉模拟量表(VAS)评分(3.93±0.92)分、PSQI评分(9.13±1.64)分高于对照组[(5.38±1.25)、(12.23±2.40)]分,对比差异有统计学意义(t=-5.902、-6.747,P<0.05);观察组并发症发生率7.50%低于对照组27.50%(χ 2 =5.541,P=0.019);手术后观察组SF-36评分相关维度[生理职能(84.45±9.74)、总体健康(60.75±10.65)、躯体疼痛(65.65±8.60)、生理功能(72.98±9.22)、活力(71.95±6.93)、社会功能(75.38±8.33)、精神健康(75.63±8.02)、情感职能(65.43±9.70)]分值高于对照组[生理职能(69.98±10.09)、总体健康(53.58±7.96)、躯体疼痛(58.83±9.35)、生理功能(65.68±7.58)、活力(62.83±12.80)、社会功能(68.98±10.99)、精神健康(71.58±9.69)、情感职能(57.90±6.86)]分值,对比差异有统计学意义(t=6.530、3.414、3.398、3.870、3.966、2.936、2.037、4.004,P<0.05)。结论   针对肾肿瘤患者术后应用基于RoSCo评分系统的早期下床活动时机干预可促进其术后康复,辅助减轻术后疼痛程度,提升睡眠质量,降低并发症发生率,进一步提升患者生活质量。
      Objective  To explore the application effect of early mobilization timing  based on the Risk of  Surgical Complication(RoSCo)scoring system in renal tumor patients after surgery.Methods  From June 2021 to June 2024,80 patients with renal tumors admitted to the hospital were selected as the research subjects.They were  randomly divided into an observation group and a control group using a random number table method,with 40 patients in each group.All patients underwent laparoscopic partial nephrectomy.The control group received routine care and early postoperative mobilization intervention,while the observation group received routine care and early mobilization intervention based on the RoSCo scoring system.The postoperative rehabilitation level,pain level and sleep quality,incidence of complications,and quality of life between two groups were compared.Results  The first time getting out of bed,exhaust,defecation and postoperative hospitalization time in observation group([19.30±4.17]h,[22.03±4.15]h,[29.93±5.58]h,[5.35±1.33]h) were shorter than those in control group([25.08±5.11]h,[29.38±5.75]h,[34.20±5.98]h,[7.35±2.38]h),the  differences  were  statistically significant(t=-5.540,-6.557,-3.308,-4.637,all P<0.05).After operation,VAS score(3.93±0.92)and PSQI score(9.13±1.64)in the observation group were higher than those in the control group([5.38±1.25]and[12.23±2.40]),and the differences were statistically significant(t=-5.902,-6.747,both P<0.05).The complication  rate of the observation group (7.50%) was lower than that of the control group(χ 2 =5.541,P=0.019).After operation,SF-36 scores in the observation group were physiological function(84.45±9.74),general health(60.75±10.65),physical pain(65.65±8.60),physiological function(72.98±9.22),vitality(71.95±6.93),social function(75.38±8.33),spiritual health(75.63±8.02)and emotional function(65.43±9.70),which were higher than those of the control group(physiological function[69.98±10.09],general health[53.58±7.96],physical pain[58.83±9.35],physiological function[65.68±7.58]and vitality[62.83±12.80],social function[68.98±10.99],mental health[71.58±9.69],emotional function[57.90±6.86]),and the differences were statistically significant(t=6.530,3.414,3.398,3.870,3.966,2.936,2.037,4.004,all P<0.05)Conclusions  Early mobilization intervention based on the RoSCo scoring system can promote postoperative recovery,assist in reducing postoperative pain,improve sleep quality,reduce the incidence of complications,and further enhance the quality of life of patients with renal tumors.
论著

血清胱抑素C、同型半胱氨酸及尿微量白蛋白在高血压患者肾损害早期评估中的应用价值

The application value of serum cystatin C,homocysteine and urinary microalbumin in early assessment of renal damage in hypertensive patients

:875-880
 
目的 探讨血清胱抑素C(SCys-C)、同型半胱氨酸(Hcy)及尿微量白蛋白(UmAlb)在高血压患者肾损害早期评估中的应用价值。方法 选择2022年9月—2023年9月期间福建中医药大学附属第三人民医院接收的150例高血压患者作为观察组,另选择健康体检者150例为对照组,测定肾小球滤过率(GFR)、SCys-C、Hcy、UmAlb,比较不同血压程度及对照组的各指标水平,比较观察组各指标检测阳性率及诊断符合率,依据GFR值评估肾损害程度,比较不同肾损害程度患者的SCys-C、Hcy、UmAlb水平。结果 高血压2级、高血压3级患者SCys-C、Hcy、UmAlb水平高于高血压1级患者(t=5.255、10.976、21.578,P<0.05;t=7.378、18.012、23.708,P<0.05)及对照组患者(t=8.308、19.675、31.891,P<0.05;t=10.661、31.511、21.578,P<0.05),高血压3级患者高于高血压2级患者(t=2.776、12.725、7.779,P<0.05)。观察组肾损害患者SCys-C、Hcy、UmAlb的阳性率79.41%、73.53%、83.82%高于无肾损害患者的阳性率6.10%、4.88%、6.10%(χ2=83.733、76.040、92.613,P<0.05)。观察组中重度肾损害、轻度肾损害患者的SCys-C、Hcy、UmAlb水平高于无损害患者(t=7.567、24.214、30.836,P<0.05;t=5.783、16.054、25.164,P<0.05),中重度肾损害高于轻度肾损害患者(t=2.685、7.179、9.561,P<0.05)。结论 高血压分级越高患者的SCys-C、Hcy、UmAlb水平越高,各指标联合检测的阳性率高,而且SCys-C、Hcy、UmAlb水平越高,肾损害程度越严重。
Objective To explore the application value of serum cystatin C(SCys-C),homocysteine(Hcy) and urinary microalbumin(UmAlb)in early assessment of renal damage in hypertensive patients.Methods A total of 150 hypertensive patients admitted to the Third People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from September 2022 to September 2023 were selected as the observation group,and 150 healthy individuals were selected as the control group.Glomerular filtration rate(GFR),serum cystatin C(SCys-C),homocysteine(Hcy),and UmAlb were measured,and the levels of various indicators in different blood pressure levels and the control group were compared.The positive rate and diagnostic accuracy of each indicator in the observation group were compared,and the degree of renal damage was evaluated based on GFR values.The levels of SCys-C,Hcy and UmAlb in patients with different degrees of renal damage were compared.Results The levels of SCys-C,Hcy and UmAlb in patients with grade 2 and grade 3 hypertension were significantly higher than those in patients with grade 1 hypertension(t=5.255,10.976,21.578,P<0.05;t=7.378,18.012,23.708,P<0.05),as well as in the control group(t=8.308,19.675,31.891,P<0.05;t=10.661,31.511,21.578,P<0.05),patients with grade 3 hypertension were significantly higher than those with grade 2 hypertension(t=2.776,12.725,7.779,P<0.05).The positive rates of SCys-C,Hcy and UmAlb in patients with renal injury in the observation group were 79.41%,73.53% and 83.82%,which were significantly higher than the positive rates of 6.10%,4.88% and 6.10% in patients without renal injury(χ2=83.733,76.040,92.613,P<0.05).The levels of SCys-C,Hcy and UmAlb in patients with severe and mild kidney damage in the observation group were significantly higher than those in patients without damage(t=7.567,24.214,30.836,P<0.05;t=5.783,16.054,25.164,P<0.05),patients with moderate to severe kidney damage were significantly higher than those with mild kidney damage(t=2.685,7.179,9.561,P<0.05).Conclusions The higher the grading of hypertension,the higher the levels of SCys-C,Hcy and UmAlb in patients,and the higher the positive rate of combined detection of various indicators.Moreover,the higher the levels of SCys-C,Hcy and UmAlb,the more severe the renal damage.
论著

癌症患者生命质量测定量表体系之肾癌量表(QLICP-RE V2.0)的条目筛选

Items selection on the Specific Module of Quality of Life Instruments for patients with renal cancer(QLICP-REV2.0)

:77-81
 
目的 开发适合中国肾癌患者的生命质量测定量表的特异模块。方法 采用议题小组和核心小组的程序化决策方式,提出条目池,形成初步量表,采用医生及患者重要性评分法、相关系数法、变异度法、因子分析法和克朗巴赫系数α对20例肾癌患者和20名医护人员进行的数据进行统计分析。结果 经过上述方法进行筛检,结合专家小组的建议,最终得到含有11个条目的肾癌生命质量测定量表的特异模块。结论 肾癌的生命质量测定量表特异模块严格按照程序执行,具有较好的内容效度。
Objective To develop the specific module of the quality of life instruments for patients with renal cancer(QLICP-RE).Methods With the structured group(nominal group and focus group)methods,the item pool was put forward and a preliminary instrument was formed.The data from 20 renal cancer patients and 20 doctors/nurses were analyzed by statistical procedures.Doctors and patients' importance rating procedure,correlation analysis,method of coefficient of variation,factor analysis,and Cronbach's α.Results By above statistical procedures and advises of expert panel,11-items of the specific module were formed finally.Conclusions The specific module of QLICP-RE developed on the strict procedures has good content validity and representativeness.
论著

宣清导浊汤加减方联合血液透析治疗对老年慢性肾衰竭患者微炎症状态和毒素清除率的影响

The effect of Xuanqing Daozhuo Decoction modified formula combined with hemodialysis treatment on renal function,microinflammatory status,and toxin clearance in elderly patients with chronic renal failure

:25-29
 
目的 探讨宣清导浊汤加减方联合血液透析治疗对老年慢性肾衰竭(CRF)患者肾功能、微炎症状态和毒素清除率的影响。方法 回顾性选取2019年10月—2022年10月我院收治的82例老年CRF患者,将其根据治疗方法分为联合组与单一组,每组41例。单一组仅采取血液透析治疗,联合组联合宣清导浊汤加减方治疗,对比两组患者治疗前后中医证候积分、毒素清除率、炎症因子变化。结果 治疗后,两组患者口淡不渴、肢体麻木、腰膝酸软、倦怠乏力、食少纳呆以及面色晦暗相关中医证候积分均降低,且联合组低于单一组(P<0.05);治疗后两组患者血肌酐、尿素氮、血β2-微球蛋白均降低,联合组低于单一组(P<0.05);治疗后两组患者白细胞介素-6、C-反应蛋白、肿瘤坏死因子-α炎性因子水平明显降低,且联合组更低(P<0.05)。两组在治疗期间均无不良反应。结论 宣清导浊汤加减方联合血液透析治疗老年CRF患者效果较佳,可通过降低机体炎症因子表达水平、提高毒素清除率来改善患者临床症状,且不会增加不良反应。
Objective To explore the effect of Xuanqing Daozhuo Decoction modified formula combined with hemodialysis treatment on renal function,micro inflammatory status,and toxin clearance rate in elderly patients with chronic renal failure(CRF).Methods Retrospectively,82 elderly CRF patients admitted to our hospital from October 2019 to October 2022 were selected and divided into a combination group and a single group according to the treatment methods,with 41 cases in each group. The single group was treated with hemodialysis only,and the combined group was treated with Xuanqing Daozhuo Decoction modified formula additionally.The changes of TCM syndrome scores,toxin clearance rate and inflammatory factors before and after treatment were compared between the two groups.Results After treatment,the scores of TCM syndroms including tasteless mouth and no thirst,numbness of limbs,soreness and weakness of waist and knee,fatigue,poor appetite and sluggish stomach were all decreased in 2 groups,and those in combined group were lower(P<0.05).After treatment,serum creatinine,blood urea nitrogen and β2-microglobulin were decreased in 2 groups,and those in combined group were lower(P<0.05).After treatment,the levels of interleukin-6,C-reactive protein and tumor necrosis factor-α inflammatory factors were significantly decreased in 2 groups,which were lower in combination group(P<0.05).The two groups had no adverse effects during the treatment period.Conclusions Xuanqing Daozhuo Decoction modified formula and hemodialysis can improve the clinical symptoms of elderly patients with CRF,reduce the expression level of inflammatory factors in patients,and increase the clearance rate of toxins in patients,and does not increase the adverse effects.
论著

恩格列净对2型心肾综合征患者的治疗效果分析

Analysis of treatment of empagliflozin for patients with type 2 cardio-renal syndrome

:648-652
 
目的 分析恩格列净对2型心肾综合征(CRS)患者的治疗效果。方法 研究于2021年10月—2023年10月进行,随机抽取88例2型CRS患者,经计算机程序随机分成对照组(44例,给予常规治疗)、实验组(44例,在常规治疗的同时加用恩格列净),通过对比两组患者心、肾功能指标来评估疗效,并记录两组患者治疗过程中发生的不良反应。结果 治疗后,实验组LAD、LVED低于对照组,而LVEF高于对照组;实验组血清肌酐、尿酸等肾功能指标水平均低于对照组(均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 对于2型CRS患者,恩格列净可促进其心、肾功能的改善,且无过多不良反应,安全性理想,治疗效果可观,值得推广。
Objective To analyze the therapeutic effect of empagliflozin on patients with type 2 cardiorenal syndrome(CRS).Methods The study was conducted from October 2021 to October 2023,and 88 patients with type 2 CRS were randomly selected and divided into control group(44 cases,receiving conventional treatment)and experimental group(44 cases,receiving conventional treatment combined with englaglitzin)by computer program.The efficacy was evaluated by comparing cardiac and renal function indexes and adverse reactions.Results After treatment,the LAD and LVED of the experimental group were lower than those of the control group,while LVEF was higher than that of the control group.The levels of serum creatinine,uric acid and other renal function indexes in the experimental group were lower than those in the control group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions For patients with type 2 CRS,empagliflozin can promote the improvement of cardiac and renal function without many side effects,with ideal safety and considerable therapeutic effect,which is worthy of promotion.
论著

福辛普利钠联合多沙唑嗪治疗对肾性高血压患者血压控制及相关生物活性因子的影响

Effects of fosinopril sodium combined with doxazosin on blood pressure control and related bioactive factors in patients with renal hypertension

:1060-1065
 
目的 探讨福辛普利钠与多沙唑嗪联合对肾性高血压的治疗效果,并分析治疗后患者血压控制情况及相关活性因子变化。方法 前瞻性选取天津市北辰区北辰医院2020年10月—2023年10月收治的98例肾性高血压患者,以随机数字表法作为分组方式,分为观察组(n=49)与对照组(n=49)。对照组患者采取福辛普利钠治疗,观察组在对照组基础上增加多沙唑嗪治疗。对比两组的血压控制效果,治疗前后一氧化氮(NO)、内皮素(ET)、血管紧张素Ⅱ(AngⅡ)相关生物活性因子水平变化,肾功能变化,不良反应发生情况。结果 观察组总有效率89.79%,高于对照组的73.47%(χ2=4.356,P=0.037);治疗后两组AngⅡ、ET水平均降低,且观察组[(13.62±2.24)ng/mL、(68.62±6.66)ng/L]低于对照组[(16.25±4.32)ng/mL、(74.26±9.35)ng/L],对比差异有统计学意义(t1=3.783,t2=3.439,P<0.001);NO水平升高,观察组[(54.26±3.42)μmol/L]高于对照组[(50.51±2.37)μmol/L],对比差异有统计学意义(t=6.309,P<0.001);治疗后两组血肌酐(Scr)、尿素氮(BUN)、胱抑素C(CysC)水平均降低,且观察组[(404.36±92.12)μmoI/ L、(13.34±4.31)mmol / L、(2.19±0.24)mg / L]低于对照组[(443.49±80.19)μmoI / L、(15.07±4.23)mmol / L、(2.87±0.38)mg / L],对比有统计学意义(t1=2.243,P1=0.027;t2=2.005,P2=0.048;t3=10.591,P3<0.001);两组不良反应发生率对比差异无统计学意义(10.20% vs 8.16%,P>0.05)。结论 对肾性高血压患者,采取福辛普利钠与多沙唑嗪联合治疗可提升其血压控制效果,改善血管内皮功能,降低血管紧张素Ⅱ表达水平,改善肾功能,且不增加不良反应。
Objective To explore the therapeutic effect of the combination of fosinopril sodium and doxazosin on renal hypertension,and to analyze the blood pressure control and changes in related active factors in patients after treatment.Methods A prospective study was conducted on 98 patients with renal hypertension admitted to Beichen Hospital from October 2020 to October 2023.Random number table method was used as the grouping method,and they were divided into an observation group(n=49)and a control group(n=49).The control group patients were treated with fosinopril sodium,while the observation group was treated with doxazosin additionally.The blood pressure control effect,changes in levels of NO,ET,Ang II related bioactive factors,renal function changes before and after treatment,and their adverse reactions were compared.Results The total response rate in the observation group was 89.79%,which was higher than 73.47% in the control group(χ2=4.356,P=0.037).Ang Ⅱ and ET levels in both groups decreased after treatment,the observation group[(13.62±2.24)ng/mL,(68.62±6.66)ng/L] was lower than the control group[(16.25±4.32)ng/mL,(74.26±9.35)ng/L],the difference was statistically significant(t1=3.783,t2=3.439,P<0.001).Elevated NO levels in the observation group[(54.26±3.42)μmol/L] was higher than the control group[(50.51±2.37)μmol/L],the difference was statistically significant(t=6.309,P<0.001).Blood Scr,BUN,and CysC levels were decreased in both treatment groups,and those in observation group[(404.36±92.12)μmoI/L,(13.34±4.31)mmol/L,(2.19±0.24)mg/L] were lower than the control group[(443.49±80.19)μmoI/L,(15.07±4.23)mmol/L,(2.87±0.38)mg/L],the differences were statistically significant(t1=2.243,P1=0.027;t2=2.005,P2=0.048;t3=10.591,P3<0.001;P<0.05).There was no difference in the incidence of adverse effects between the two groups(10.20% vs 8.16%,P>0.05).Conclusions The combination treatment of fosinopril sodium and doxazosin can improve the blood pressure control effect,improve endothelial function,reduce the expression level of angiotensin II,and improve renal function in patients with renal hypertension,with high safety.
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