连续性血液净化对糖尿病肾病酮症酸中毒合并急性肾损伤血液动力学的影响
The effect of continuous blood purification on hemodynamic in patients with diabetic ketoacidosis and acute kidney injuryZhang yuanpeng People

张远鹏.连续性血液净化对糖尿病肾病酮症酸中毒合并急性肾损伤血液动力学的影响[J].内科急危重症杂志,2016,22(1):

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英文关键词:diabetic ketoacidosis acute kidney injury continuous blood purification hemodynamic

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作者	单位	E-mail
张远鹏	佛山市高明区人民医院	wszhangyuanpeng123@163.com

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中文摘要:

目的：探讨连续性血液净化(CBP)对糖尿病肾病酮症酸中毒(DKA)合并急性肾损伤血液动力学的影响。方法：回顾性分析2011年6月~2015年5月间收治的102例经普通血液透析IHD(44例)或CBP(58例)治疗的DKA合并急性肾损伤患者的血液动力学变化指标,利用Student’s t或卡方检验比较两组间各指标的差异。结果：经血液透析治疗后,两组的CVP、CO、SVR、CI和TFC均显著降低(P均<0.05),且CBP组的CVP(t=3.97, P<0.01)、SVR(t=12.54, P<0.01)、CI(t=7.16, P<0.01)和TFC(t=3.83, P<0.01)显著低于IHD组,更趋于正常,而CBP组的MAP(X₂=7.54, P=0.01)、CVP(X₂=8.63, P<0.01)和SVR(X₂=7.32, P=0.01)的恢复率也显著高于IHD组。结论：CBP可使DKA合并急性肾损伤的血液动力学指标趋于正常,且对其指标的恢复效果优于IHD,因此对血液动力学的影响较小。

英文摘要:

Object: To explore the effect of continuous blood purification (CBP) on hemodynamic in patients with diabetic ketoacidosis and acute kidney injury (DKI). Method: A retrospective analysis of hemodynamic data in 102 patients with DKI (44 were treat by ordinary blood purification, IHD, and 58 by CBP) during June 2012 to May 2015, then Student"s t and chi-square test were used to compare these data between the two groups. Results: After blood purification, the CVP, CO, SVR, CI and TFC in the two groups were significantly reduced (P<0.05), and CVP (t=3.97, P<0.01), SVR (t=12.54, P<0.01), CI (t=7.16, P<0.01) and TFC (t=3.83, P<0.01) were significantly lower in CBP than IHD group, while recover rate of MAP (X₂=7.54, P=0.01), CVP (X₂=8.63, P<0.01) and SVR (X₂=7.32, P=0.01) in CBP were significantly higher in CBP than IHD group. Conclusion: CBP can significantly reduce hemodynamic in patients with DKI, and the recover effect of that indicators in CBP were better than IHD, so CBP have litter effect on hemodynamic.