[關(guān)鍵詞]
[摘要]
目的 分析柳氮磺吡啶初始治療腹膜透析相關(guān)腹膜炎的臨床應(yīng)用價值。方法 選取萬寧市人民醫(yī)院2020年1月—2022年1月收治的120例腹膜透析相關(guān)腹膜炎患者,按照隨機(jī)分組法分為對照組(60例)和治療組(60例)。兩組均給予連續(xù)性非臥床腹膜透析。對照組患者給予常規(guī)初始治療,包括腹膜透析、抗感染干預(yù)和基礎(chǔ)干預(yù)。治療組在對照組基礎(chǔ)上口服柳氮磺吡啶腸溶片,初始劑量1 g/次,若無不適則增至2 g/次,3次/d。兩組均治療3 d,3 d后根據(jù)患者病情調(diào)整治療方案。觀察兩組患者臨床療效,比較治療前后兩組患者臨床癥狀消失時間,透析液高敏C反應(yīng)蛋白(hs-CRP)、白細(xì)胞介素-6(IL-6)、中性粒細(xì)胞明膠酶相關(guān)脂質(zhì)運載蛋白(NGAL)和血液血小板/淋巴細(xì)胞(PLR)、中性粒細(xì)胞/淋巴細(xì)胞(NLR)水平,及腸道屏障功能。結(jié)果 治療后,治療組總有效率(88.33%)明顯高于對照組(70.00%,P<0.05)。治療組腹痛、腹脹、惡心消失時間較對照組顯著縮短(P<0.05)。治療后,兩組透析液hs-CRP、IL-6、NGAL及血液PLR、NLR水平低于治療前(P<0.05),且治療組較明顯低于對照組(P<0.05)。治療后,兩組乳果糖排泄率較治療前降低、甘露醇排泄率較治療前提高(P<0.05),且治療組改善幅度更顯著(P<0.05)。結(jié)論 柳氮磺吡啶初始治療腹膜透析相關(guān)腹膜炎具有確切效果,可有效緩解炎癥反應(yīng),且對腸道屏障功能恢復(fù)有一定作用,安全可靠。
[Key word]
[Abstract]
Objective To analyze the clinical value of sulfasalazine for the initial treatment of peritoneal dialysis-associated peritonitis. Methods Patients (120 cases) with peritoneal dialysis-associated peritonitis in People's Hospital of Wanning from January 2020 to January 2022 were divided into control (60 cases) and treatment (60 cases) group by random grouping method. Patients in two groups were given continuous ambulatory peritoneal dialysis. Patients in the control group were given routine initial treatment, including peritoneal dialysis, anti-infective intervention and basic intervention. Patients in the treatment group were po administered with Sulfasalazine Enteric-Coated Tablets on the basis of the control group, the initial dose was 1 g/time, and if there was no discomfort, the dose was increased to 2 g/time, 3 times daily. Patients in two groups were treated for 3 d, and the treatment plan was adjusted according to the patient's condition after 3 d. After treatment, the clinical evaluation was evaluated, and the disappearance time of clinical symptoms, dialysate hs-CRP, IL-6, NGAL and blood PLR, NLR levels, and intestinal barrier function in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (88.33%) was significantly higher than that of the control group (70.005%, P < 0.05). The disappearance time of abdominal pain, abdominal distension and nausea in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the levels of hs-CRP, IL-6, and NGAL in dialysate and blood PLR and NLR in two groups were lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the lactulose excretion rate in two groups was significantly decreased and the mannitol excretion rate was significantly increased (P < 0.05), and the improvement in the treatment group was significantly higher than that in the control group (P < 0.05). Conclusion Sulfasalazine has a definite effect in the initial treatment of peritoneal dialysis-related peritonitis, can effectively alleviate the inflammatory reaction, and has a certain effect on the recovery of intestinal barrier function, which is safe and reliable.
[中圖分類號]
R977
[基金項目]
海南省衛(wèi)生健康行業(yè)科研項目(19A200142)