摘要
Abstract
Objective To observe the clinical efficacy and safety of icodextrin(ICO)peritoneal dialysis solution in elderly patients with peritoneal dialysis(PD)and heart failure(HF).Methods Elderly PD patients with HF were randomly divided into treatment group and control group.Both groups were treated with low calcium peritoneal dialysate 4.5 L+oral sacubatro/valsartan capsules(SV)with an initial dose of 50 mg,twice a day,and then the dose was adjusted to the maximum tolerated dose according to the patient's blood pressure as the basic treatment.In addition,the treatment group used 7.5％ICO 2L for long-term peritoneal dialysis at night for 12 hours,while the control group used low calcium peritoneal dialysate at night for 6-8 hours.Both groups were treated for 4 months.The cardiac function,blood glucose index,dialysis adequacy,clinical efficacy and safety of the two groups were compared.Results A total of 124 patients were included,including 62 cases in treatment group and 62 cases in control group.The left ventricular ejection fraction(LVEF)of treatment group and control group were(58.65±5.72)％and(56.20±6.03)％,respectively;fasting blood glucose were(4.28±0.61)and(4.53±0.46)mmol·L-1,respectively;glycosylated hemoglobin(HbA1c)were(5.46±1.08)％and(6.00±1.29)％,respectively.The LVEF of treatment group was significantly higher than that of control group;the fasting blood glucose and HbA1c of treatment group were significantly lower than those of control group(all P＜0.05).The weekly urea clearance index of treatment group and control group were 2.78±0.70 and 2.50±0.59,respectively;the weekly creatinine clearance rates were(2.54±0.48)and(2.22±0.81)l·1.73 m2,respectively.The above indicators in treatment group were significantly higher than those in control group(all P＜0.05).In addition,the daily ultrafiltration volume in treatment group was(982.40±90.79)mL,which was significantly higher than(433.39±66.13)mL in control group(P＜0.05).The adverse drug reactions in treatment group were mainly hypotension,nausea and vomiting,hyperkalemia and rash,while those in control group were mainly hypotension,vascular water,hyperkalemia and rash.The total incidence of adverse drug reactions in treatment group and control group were 11.29％and 16.13％,respectively,with no statistically significant difference(P＞0.05).Conclusion The effects of ICO long stay in the abdomen on elderly patients with PD complicated with HF is significant,which can improve the cardiac function,the adequacy of dialysis,help to maintain the relative stability of glucose metabolism,and has good safety.关键词
艾考糊精腹膜透析液/腹膜透析/长留腹/心力衰竭/老年Key words
icodextrin dialysate/peritoneal dialysis/long abdomen/heart failure/elder分类
医药卫生
