三种血液净化方式对维持性血液透析患者残余肾功能的影响  

Impact of three blood purification method on residual renal function of patients with maintenance hemodialysis

作　　者：李阳[1] 王平[1] 王国祥[1] 徐圣君[1] 张毅[1] 

机构地区：[1]四川成都市第五人民医院ICU,611130

出　　处：《中国临床保健杂志》2017年第1期55-58,共4页Chinese Journal of Clinical Healthcare

基　　金：2014年四川省科技计划项目(2014SZ0095)

摘　　要：目的探讨高通量血液透析(HFHD)、低通量血液透析并血液灌流(LFHD+HP)、低通量血液透析(LFHD)对维持性血液透析患者(MHD)残余肾功能的影响。方法回顾性分析行MHD治疗82例尿毒症患者的病例资料。根据血液净化方式的不同,将82例患者分为HFHD组、LFHD+HP组、LFHD组。HFHD组使用Fx80透析器,LFHD+HP组使用F7HPS透析器和HA130血液灌流器,LFHD组使用F7HPS透析器。治疗前、后采集患者血、尿标本。计算残余肾功能(RRF)值,并检测患者血液β2微球蛋白、三酰甘油、胆固醇、血磷浓度和C反应蛋白(CRP)水平。结果治疗后三组RRF水平显著降低(P<0.05),HFHD组、LFHD+HP组RRF水平显著高于LFHD组(P<0.05),而HFHD组、LFHD+HP组RRF水平比较无统计学意义(P>0.05)。治疗后,HFHD组、LFHD+HP组三酰甘油、胆固醇、血磷、β2微球蛋白和CRP水平显著降低(P<0.05),且各指标水平均显著低于LFHD组(P<0.05),而HFHD组、LFHD+HP组间各指标比较,差异无统计学意义(P>0.05)。结论HFHD和LFHD+HP可有效改善维持性血液透析患者血脂和血磷水平,保护RRF,缓解残余肾功能的衰退。Objective To explore the impact of high flux hemodialysis （HFHD）, low-flux hemodialysis combined hemoperfusion （LFHD ＋ HP） ,low-flux hemodialysis （LFHD） on residual renal function of patients with mainte- nance hemodialysis （MHD）. Methods Eighty-two cases of uremic patients treated with MHD were retrospectively analyzed. Patients were divided into HFHD group, LFHD ＋ HP group and LFHD group by blood purification methods, Patients of HFHD group were given Fx80 dialyzer,patients of LFHD ＋ HP group were given F7HPS dialysis and hemoperfusion HA130, and patients of LFHD group were given F7HPS dialyzer. Before and after treatment, urine and blood samples were collected. The residual renal function （RRF） value were calculated and β2 mieroglobulin, triglycefides, cholesterol C-reactive protein （CRP） levels were detected. Results After treatment, RRF levels of three groups were significantly decreased （P 〈 O. 05 ）, RRF levels of HFHD and LFHD ＋ HP group were significantly higher than LFHD group （ P 〈 0. 05 ）, there was no statistically significance between HFHD group and LFHD ＋ HP group （ P 〉 0. 05 ）. After treatment,triglycerides, cholesterol, phosphorus, β2-microglobulin and CRP levels of HFHD group and LFHD ＋ HP group were significantly decreased （ P 〈 0. 05 ） and significantly lower than LFHD group （ P 〈 0.05 ）. and there was no statistically significance between HFHD group and LFHD ＋ HP group （ P 〉 0. 05 ）. Conclusion The high-flux hemodialysis and hemodialysis combined hemoperfusion can effectively improve the blood lipids and serum phosphate levels of patients with maintenance hemodialysis, protect the RRF and relieve decline of residual renal function.

关 键 词：肾透析 灌流 肾功能不全 

分 类 号：R692.5[医药卫生—泌尿科学]