Department of Nephrology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.
Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China.
Ren Fail. 2020 Nov;42(1):987-993. doi: 10.1080/0886022X.2020.1822867.
This study aimed to compare the efficacy of intravenous sodium thiosulfate (IV STS) with that of loratadine in the treatment of uremic pruritus in hemodialysis (HD) patients.
This retrospective study included 44 HD patients with pruritus aged over 18 years between June 2018 and January 2020 at the Aerospace Center Hospital of China. Twenty-four HD patients received 3.2 g IV STS treatment three times per week at the end of each HD session for 8 weeks. Twenty HD patients received loratadine (10 mg/day) for 8 weeks. Pruritus intensity was measured using a visual analog scale (VAS) and the detailed pruritus score (DPS) at three time points. The safety of STS was evaluated according to adverse event symptoms and biological variable changes.
There was no significant difference between the STS and loratadine groups in age, sex, characteristics of pruritus, or other clinical variables before treatment. After 8 weeks of treatment, the VAS score (7.07 ± 2.56 and 2.67 ± 2.01) and DPS (30.72 ± 4.81 and 8.04 ± 2.86) decreased significantly in the STS group ( < 0.05). The mean decrease in VAS score (6.89 ± 1.98 and 6.34 ± 2.35) and DPS (28.90 ± 3.24 and 26.92 ± 2.41) in the loratadine group was not statistically significant ( > 0.05). There were no morbidities or mortalities associated with the use of either drug. All biological variables remained stable after therapy.
STS can improve uremic pruritus in HD patients. However, literature on the subject remains lacking. Close monitoring for adverse effects is advised.
本研究旨在比较静脉注射硫代硫酸钠（IV STS）与氯雷他定在治疗血液透析（HD）患者尿毒症瘙痒中的疗效。
本回顾性研究纳入了 2018 年 6 月至 2020 年 1 月在中国航天中心医院接受治疗的 44 例年龄超过 18 岁的瘙痒性 HD 患者。24 例 HD 患者在每次 HD 治疗结束时每周接受 3 次 3.2 g IV STS 治疗，共 8 周。20 例 HD 患者接受氯雷他定（10 mg/天）治疗 8 周。瘙痒强度采用视觉模拟量表（VAS）和详细瘙痒评分（DPS）在三个时间点进行测量。根据不良反应症状和生物变量变化评估 STS 的安全性。
STS 组和氯雷他定组在治疗前的年龄、性别、瘙痒特征或其他临床变量方面无显著差异。治疗 8 周后，STS 组的 VAS 评分（7.07±2.56 和 2.67±2.01）和 DPS（30.72±4.81 和 8.04±2.86）显著降低（ < 0.05）。氯雷他定组 VAS 评分（6.89±1.98 和 6.34±2.35）和 DPS（28.90±3.24 和 26.92±2.41）的平均下降无统计学意义（ > 0.05）。两种药物均无与使用相关的发病率或死亡率。治疗后所有生物变量均保持稳定。
STS 可改善 HD 患者的尿毒症瘙痒，但相关文献仍较少。建议密切监测不良反应。
