高通量血液透析患者的状态研究  

Status research on high-flux hemodialysis patients

作　　者：葛玉英[1] 赵宁[1] 

机构地区：[1]杭州市第一人民医院血液透析室,浙江杭州310006

出　　处：《中国现代医生》2016年第14期19-22,共4页China Modern Doctor

基　　金：浙江省科技计划项目(2014C33237)

摘　　要：目的研究高通量血液透析对维持性血液透析患者（maintain hemodialysis，MHD）的微炎症、心室结构的影响，明确维持性血液透析患者的有效治疗方式。方法选择我院2013年12月～2014年12月收治的共60例维持性血液透析患者作为研究对象，随机分为对照组和研究组，均为30例，分别对患者进行常规血液透析及高通量血液透析治疗。对两组患者的临床指标、超声心动图进行检测，对比观察治疗前、治疗6个月、12个月后两组患者的血清肌酐、P3＋的清除效果，分析微炎症状态、营养指标等差异。结果经过1年的积极治疗，两组患者的病情和症状均得到明显改善。在P3＋清除效果方面，两组患者的P3＋含量均降低，研究组治疗后P3＋浓度低于对照组，且研究组在治疗前后P3＋浓度比较差异有统计学意义（P〈0．05）；在血清肌酐清除效率方面，两组患者治疗后的肌酐浓度相差不大，差异无统计学意义（P〉O．05）；在营养指标改善方面，同对照组比较，研究组治疗后白蛋白明显提高，差异具有统计学意义（P〈0．05）；在微炎症指标改善方面，研究组患者在治疗后基质金属蛋白酶-2明显降低，降低程度优于对照组，差异具有统计学意义（P〈0．05）。结论对维持性血液透析患者进行高通量血液透析治疗能够有效缓解患者的微炎症状态。使患者的营养状况得到很大的改善，临床应用价值极高。Objective To study the effects of high-flux hemodialysis （HFHD） on micro-inflammation and ventricular structure in maintain hemodialysis （MHD） patients, and to discover the effective therapy for MHD patients. Methods A total of 60 MHD patients treated in our hospital from December 2013 to December 2014 were selected and randomly divided into control group and study group, each with 30 patients. Patients in the two groups were given conventional hemodialysis and HFHD, respectively. The clinical indicators and ultrasonic cardiogram of patients in both groups were detected, levels of serum creatinine and clearance effects of P3＋ before and after 6 months and 12 months of treatment were observed and compared, and status of micro-inflammation and nutritive indexes were analyzed. Results After a year of treatment, the conditions of patients in both groups were significantly improved. The levels of P3 ＋ in both groups were reduced, and the clearance effect in the study group was more significant than that in the control group and that before treatment（P〈0.05）. There was no significant difference in clearance effect of serum creatinine between two groups（P〉0.05）. As to nutritive index, the level of albumin in the study group after treatment was significantly higher than that in the control group（P〈0.05）. Levels of micro-inflammation indicators such as matrix metalloproteinase-2 in the study group were significantly lower after treatment than those before treatment, and the reduction of these levels was more significant in the study group than in the control group（P〈0.05）. Conclusion HFHD in MHD patients can effectively relieve the micro-inflammation status and significantly improve the nutritional status of patients, showing high clinical application value.

关 键 词：高通量血液透析 透析患者 微炎症状态 营养状况 

分 类 号：R459.5[医药卫生—治疗学]