高通量血液透析对维持性血液透析患者营养状态的影响  

Impacts of high flux hemodialysis on nutritinal status in maintenance hemodialysis patients

作　　者：王静艳[1] 赵伟[1] 薄天慧[1] 高秀[1] 

机构地区：[1]北京大学首钢医院肾内科,北京100144

出　　处：《国际移植与血液净化杂志》2016年第1期30-33,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的 研究高通量血液透析对维持性血液透析患者透析期间营养状态的影响.方法 采用前瞻性、自身对照设计.44例常规低通量血液透析患者转换为高通量透析（Fresenius FX60-FX80,超纯透析液）治疗半年.采用单因素方差分析比较试验前（0月）、试验后6个月与试验后12个月患者食欲评分、主观综合性营养评估、体质指数、透析前血肌酐、尿素氮、尿酸、血磷、血钙、全段甲状旁腺激素、白蛋白、C-反应蛋白、血红蛋白、红细胞压积等指标水平的变化.结果 高通量透析6、12个月后,较低通量透析时患者食欲、主观营养评估及体质指数均有改善,差异有统计学意义.血尿素氮、肌酐、尿酸、血钙等生化指标在转化为高通量透析后与低通量时比较差异无统计学意义（均P＞0.05）.高通量透析后12个月与6个月比较,C反应蛋白、白蛋白、全段甲状旁腺激素、血磷、血红蛋白、红细胞压积等指标亦有改善,差异有统计学意义（P＜0.05）.结论 高通量透析能提高患者的食欲,改善营养状态,降低炎症指标,改善贫血和钙磷代谢紊乱,进而提高血液透析患者的生存质量.Objective To study the effects of high flux hemodialysis on nutritinal status and some biochemical indexes in hemodialysis patients.Methods The study was perspective and self-controlled.A total of 44 patients on preservation low flux hernodialysis were selected.After changing to high flux dialysis,dialysis prescription was unchanged except the change of dialyzer.Ultrapure dialysate was implied.To compare the appetite scores,subjective global assessment （SGA）,body mass index （BMI）,before dialysis serum creatinine （Cr）,blood urea nitrogen （BUN）,uric acid （UA）,serum phosphorus （P）,calcium （Ca）,intact parathyroid hormone （iPTH）,albumin （ALB）,C-reactive protein （CRP）,hemoglobin （Hb） and hematocrit （Hct%） level before changing to high flux hemodialysis and after 6 or 12 months entering this study respectively by One-way ANOVA and Chi square test.Results The appetite score was improved significandy after changing to high flux hemodialysis at 6 and 12 months （F =26.557,P =0.000）.The SGA and BMI were also improved after entering the study （χ^2 =10.910,P =0.000;F =2.563,P =0.081）.There were no differences of serum Cr,BUN,UA and Ca before and after changing to high flux hemodialysis （P 〉 0.05）.But the differences of serum Hb,Hct%,ALB,iPTH,P and CRP were significantly before and after 6 or 12 months entering the study（P 〈 0.05）.Conclusion The study showes that using high flux hemodialysis can improve appetite,SGA,BMI,microinflammatory state,anima,abnormal calcium and phosphorus metabolism and life quality in hemodialysis patients probably.

关 键 词：高通量血液透析 营养状态 生化指标 

分 类 号：R459.5[医药卫生—治疗学]