高通量血液透析和血液灌流联合血液透析对终末期糖尿病肾病临床疗效观察  

作　　者：肖胜[1] 简讯[1] 胡诗德[1] 曾蜀春[1] 王清红[1] 

机构地区：[1]川北医学院附属第二医院肾脏病科,621000

出　　处：《浙江临床医学》2015年第7期1112-1114,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨高通量血液透析（HFHD）与血液灌流联合血液透析（HP＋HD）对终末期糖尿病肾病维持性血液透析治疗的临床疗效和安全性。方法终末期糖尿病肾病患者80例，分为高通量血液透析组（HFHD）40例，血液灌流联合血液透析组（HP＋HD）40例，观察RBC、HGB、Alb、Folate、VitBl2、BUN、Cr、Cys．c、CRP、BF、PTH、B2．MG、P、FPG、PBG等指标变化。比较两组临床症状、并发症及不良反应。结果HFHD组在RBC、HGB指标改善方面优于HP＋HD组；HP＋HD组在Alb、Folate、VitBl2、CRP、TC、TG、LDL—C、HDL．C、PTH、B2-MG、P的改善方面优于HFHD组；两组FPG、PBG治疗6个月后均有下降，HFHD组较HP＋HD组下降幅度更大；HP＋HD组在皮肤瘙痒症、尿毒症脑病等好转情况优于HFHD组，差异均有统计学意义（P〈0．05）。结论两种血液净化方式对终末期糖尿病肾病临床疗效均安全有效，各有优缺点，对临床有一定的指导意义。Objective To investigate high flux hemedialysis （ HFHD ） and hemoperfusion combined with hemodialysis （ HP＋HD ） on the clinical efficacy and safety of end-stage diabetic nephropathy in hemodialysis. Methods 80 patients with end-stage diabetic nephropathy hemodialysis in patients with maintenance, were divided into high flux hemodialysis group （ HFHD group ） with 40 cases, hemoperfusion combined with hemodialysis group （HP＋HDgroup） with 40 cases, changes in RBC, HOB, Alb, Folate, VitB12, BUN, Cr, Cys-c, CRP, BF, PTH, β 2-MG, P, FPG, PBG index were recorded and studied in each group. The improvement of clinical symptoms, complications and adverse reaction were compared in the two groups of. Results RBC, HGB were better in HFHD group than HP＋HD group ; Alb, Folate, VitB12, CRP, TC, TG, LDL-C, HDL-C, PTH, beta2-MG, P improvement is better in HP＋HD group than in HFHD group; FP（i and PBO were both decreased in two groups after six months of a-eamaent, with a more reduction in HFHD group than in HP＋HD group; in pruritus uremic eneephalopathy, HP＋HD group was better.These differences were statistically significant （ P〈0.05 ） . Conclusion The two kinds of blood purification methods are safe and effective for end-stage diabetic nephropathy clinical curative effects. Controlling the advantages and avoiding the disadvantages of each method respectively is clinically valuable.

关 键 词：高通量血液透析 血液灌流 糖尿病肾病 

分 类 号：R692[医药卫生—泌尿科学]