不同血液净化方式对尿毒症患者临床指标及并发症的影响分析  

Analysis on clinical indicators and complications of uremia patient before and after different blood purification methods

作　　者：程艳[1] 孙长丽[1] 宋丹丹[1] 

机构地区：[1]郑州市第三人民医院肾内科,河南郑州450005

出　　处：《青岛医药卫生》2016年第4期261-264,共4页Qingdao Medical Journal

摘　　要：目的分析不同血液净化方式对尿毒症患者临床生化指标及并发症的影响。方法选取维持性血液透析120例患者作为研究对象,随机分为低通量透析组(HD)、血液透析滤过组(HDF)、高通量透析组(HFHD),每组40例,分别检测并比较每组患者治疗前及治疗后6个月血红蛋白(HB)、血钙(Ca)、血磷(P)、C-反应蛋白(CRP)、β2-微球蛋白(β2-MG)、甲状旁腺素(PTH)的变化;评估3组患者治疗6个月后并发症的发生情况。结果 (1)治疗6个月后,HFHD组患者血HB水平显著升高,并高于HD组(P<0.05),HD组和HDF组患者治疗前后HB水平差异无统计学意义(P>0.05);(2)与治疗前相比,HFHD组和HDF组血Ca水平显著升高(P<0.05),HD组无明显变化(P>0.05);(3)治疗后,HFHD组和HDF组血P、PTH、β2-MG水平显著降低(P<0.05),HD组3项指标无明显差异(P>0.05);(4)HFHD组患者血CRP水平显著降低,并低于HD组(P<0.05),HD组和HDF组患者治疗前后CRP水平差异无统计学意义(P>0.05);(5)HFHD治疗组患者高血压、肌肉痉挛的发生率明显低于HDF组及HD组(P<0.05)。结论与普通透析及血液透析滤过相比,高通量血液透析能有效清除毒素,减少透析并发症,改善患者生活质量。Objective To analyze the clinical indicators and complications of uremia patient before and afterdifferent blood purification methods. Methods A total of 120 maintain hemodialysis patients were selectedand divided randomly into three groups： hemodialysis （HD） , hemodiafiltration（HDF） and high fluxhemodialysis（HFHD）. There were 40 patients in each group. Biochemical indicators （include Hemoglobin,Calcium, Phosphorus, C-reactive protein, ｜32-microglobulin, Parathyroid Hormone） were detectedand analyzed before and after 6 months of treatment. Complications after 6 months of treatment was evaluatedand compared. Results （1） After 6 months treatment, Hemoglobin was significantly increased inHFHD group compared with HDF and HD group（P〈0. 05） ; and there was no difference of Hemoglobinbefore and after treatment in HD and HDF groups（P〉0. 05） ; （2） After 6 months treatment, Calciumwas were significantly increased in HFHD and HDF group compared with HD group（P〈0. 05） ; andthere was no difference of Calcium before and after treatment in HD groups（P〉0. 05） ; （3） After 6months treatment, Phosphorus, Parathyroid Hormone and ｜32-microglobulin were significantly decreasedin HFHD and HDF group compared with HD group（P〈C0. 05）. There was no difference of Phosphorus,Parathyroid Hormone and ｜32-microglobulin before and after treatment in HD groupsCPX）. 05） ; （4） After6 months treatment, C-reactive protein was significantly decreased in HFHD compared with HDF andHD group（P〈0. 05） , and there was no difference of C-reactive protein before and after treatment in HDand HDF groups（P〉0. 05） ; （5） The incidence of hypertension and muscle apasm was decreased in HFHDgroup compared with HDF and HD group（P〈0. 05）. Conclusion Compared with HD and HDF,HFHD can play a much better role in clearing macromolecule and median molecule solutes, reduce complicationand improve life quality of uremia patients.

关 键 词：高通量血液透析 血液透析滤过 血液透析 生化指标 并发症 

分 类 号：R692[医药卫生—泌尿科学]