血液透析滤过对维持性透析患者微炎症状态和营养状态的影响观察与护理  

The therapeutic effect observation of hemodiafiltration on microinflammatory state and nutritional state of patients with maintenance hemodialysis and its nursing

作　　者：袁长裕[1] 林峰[1] 郑芬[1] 陈子林[1] 

机构地区：[1]江门市新会区中医院,广东江门529100

出　　处：《中医临床研究》2015年第33期58-60,共3页Clinical Journal Of Chinese Medicine

基　　金：江门市科技局计划项目(编号:江科[2013]88号-1)

摘　　要：目的:探讨研究血液透析滤过(HDF)、高通量血液透析(HFHD)和低通量血液透析(LFHD)三种治疗方法对维持性透析(MHD)患者微炎症状态的影响和营养状态的临床疗效及护理。方法:将90名MHD患者随机分为三组:HDF组、HFHD组和LFHD组各30例。对比三组患者透析前及透析8个月后的血清CRP(C-反应蛋白)、IL-6(白细胞介素-6)、IL-8(白细胞介素-8)、TNF-a(肿瘤坏死因子-a)、Hb(血红蛋白)、Alb(血清白蛋白)、PA(前白蛋白)水平的变化及营养不良-炎症评分(MIS)比较。结果:30例HDF组患者透析8个月后CRP、IL-6、IL-8及TNF-α水平比透析前明显下降;血清Hb、Alb、PA比透析前明显升高;营养不良-炎症评分低于其他两组同期水平。其中,轻度营养不良-炎症评分共有18例,达60.0%。三组数据差异有统计学意义(P<0.05)。结论:HDF治疗改善维持性血液透析患者微炎症状态和营养状态效果优于HFHD和LFHD,值得临床推广应用。Objective： To explore the clinical therapeutic effect of hemodiafiltration（HDF）, high flux hemodialysis（HFHD） and low-flux hemodialysis（LFHD） on microinflammatory state and nutritional state of patients with maintenance hemodialysis and its nursing. Method： 90 MHD patients were randomly divided into three groups： the HDF Group, HFHD and LFHD group, 30 cases in each group. The changes in serum CRP, IL-6, IL-8, TNF-a, Hb, Alb and PA of three group patients were compared, the change of malnutrition inflammation score（MIS） was also compared. Results： The level of CRP, IL-6, IL-8, TNF-a in HDF group patients decreased significantly,the level of Hb, Alb and PA increased significantly 8 months after treatment, their malnutrition inflammation score（MIS） was lower than that of other two groups, among which there were 18 cases of mild malnutrition-inflammation score, which was up to 60%, the difference was statistically significant（P〈0.05）. Conclusion： The HDF therapy was remarkable in improving the microinflammatory state and nutritional state of patients with maintenance hemodialysis and it was worthy of clinical application.

关 键 词：血液透析滤过 微炎症状态 营养状态 疗效观察 护理 

分 类 号：R459.5[医药卫生—治疗学]