小剂量激素对透析患者微炎症状态作用的探讨

目的探讨小剂量激素在尿毒症血液透析部分难治性微炎症状态患者中的临床疗效并对其所起作用进行初步分析。方法 12例尿毒症透析患者,近期病情持续进展,符合微炎症状态标准,常规治疗无效,均采用小剂量激素[泼尼松0.5 mg/(kg.d)]试验性治疗1个月。结果 10例病情平稳,各项指标好转,其中1例出现血糖升高,加用普通胰岛素控制血糖;2例因其他并发症而死亡。结论尿毒症血透患者微炎症状态应早期积极干预治疗;小剂量激素效果肯定,使用安全;要注意掌握使用激素的禁忌证。

Therapeutic Effect of Small Doses of Glucocorticoids on Microinflammation State in Patients with Uremia

Objective To investigate the clinical effects of small doses of glucocorticoids on microinflammation state in patients with uremia.Methods 12 dialysis patients with uremia whose condition got persistently serious recently and met the diagnostic standard of microinflammation state,and no effect to conventional treatment methods were given small doses of glucocorticoids [prednisone 0.5 mg/(kg·d)] to treat them for a month as a trial treatment.Results Of 12 patients studied,10 presented stable conditions and the levels of CRP,ALB,ESR and HGB were significantty improved than before the experimental treatment beginning(P<0.05),though 1 showed high level of serum glucose which eventually controlled by using regular insulin;2 died because of other complications.Conclusion Dialysis patients with uremia involved in microinflammation state should be treated early;small doses of glucocorticoids shows positive effects and no significant side effects;contraindications of using glucocorticoids should be mastered.