加巴喷丁联合血液灌流治疗血液透析病人不宁腿综合征的疗效观察

目的:探讨加巴喷丁联合血液灌流治疗血液透析病人不宁腿综合征(RLS)的疗效.方法:选取50例维持性血液透析伴RLS病人为研究对象,随机分为2组.所有病人予常规血液透析及对症治疗;观察组病人每晚睡前口服加巴喷丁300 mg,疗程8周;并每2周给予1次血液灌流治疗.使用RLS评分量表(IRLS)评分评价病人RLS有无改善,匹兹堡睡眠质量指数评分评估治疗后病人睡眠障碍有无改善,视觉模拟(VAS)评分评价疼痛病人改善情况.并检测病人治疗前后病人血清铁蛋白、甲状旁腺素(PTH)、钙、磷等指标.结果:治疗8周后,观察组病人的RLS严重程度、PSQI和VAS评分均明显下降(P<0.01);对照组的RLS严重程度和PSQI评分也有所下降(P<0.01),但VAS评分与治疗前比较差异无统计学意义(P>0.05);观察组3指标的下降幅度均大于对照组(P<0.01).治疗后2组病人铁蛋白均有所上升(P<0.01和P<0.05),PTH、Ca、P指标治疗前后无明显变化(P>0.05).观察组病人无严重不良反应.结论:加巴喷丁联合血液灌流治疗能明显缓解病人不宁腿症状,并改善病人的睡眠质量,且没有明显不良反应.

Effect of gabapentin combined with hemoperfusion in the treatment of restless leg syndrome in hemodialysis patients

Objective:To investigate the effects of gabapentin combined with hemoperfusion in the treatment of restless leg syndrome ( RLS) in hemodialysis patients. Methods:Fifty hemodialysis patients with RLS were randomly divided into the observation group and control group. All patients were treated with routine hemodialysis combinewd with symptomatic treatment. The observation group were additionally treated with 300 mg gabapentin by oral per night combined with blood perfusion a time every week for 8 weeks. The RLS, sleep and pain improvement in two groups were assessed using the index of RLS(IRLS),Pittsburgh Sleep Quality Index(PSQI) and Visual Analogue Scale/Score(VAS),respectively. The levels of ferritin,parathyroid hormone(PTH),Ca and P in two groups were measured before and after treatment. Results:After 8 weeks of treatment,the order of severity of IRLS,and scores of PSQI and VAS in observation group decreased significantly(P <0. 01),the order of severity of IRLS,and score of PSQI in control group decreased significantly(P<0. 01),but the difference of VAS score in control group was not statistically significant compared with before treatment (P>0. 05). The decreasing degree of three indictors in observation group was more than that in control group(P<0. 01). The levels of ferritin in two groups increased after treatment(P<0. 01 and P<0. 05),and the changes of the levels of PTH,Ca and P in two groups were not obvious(P >0. 05). No severe adverse reaction in observation group was found. Conclusions:Gabapentin combined with hemoperfusion can significantly improve the RLS symptoms and sleep quality in hemodialysis patients,which has no significant adverse reaction.