透析方式与维持透析患者生活质量疗效和微炎症指标的相关性  

Correlation between Dialysis Methods and Quality of Life Efficacy and Microinflammation Indicators in Maintaining Dialysis Patients

作　　者：麻冰 虞妙婷[1] 马丽[1] 何帆[1] 杨文君[1] MA Bing;YAN Miaoting;MA Li(The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830000, China)

机构地区：[1]新疆医科大学第一附属医院血液科

出　　处：《河北医学》2020年第3期384-389,共6页Hebei Medicine

基　　金：新疆维吾尔自治区自然科学基金项目，(编号:2017D01C293)

摘　　要：目的:探究维持透析患者生活质量及透析方式、疗效和微炎症指标的相关性。方法:选取2018年1月至2019年1月间于我院行透析治疗的90例终末期肾病患者,随机分为A,B,C三组,每组30人,分别行血液透析滤过(HDF),高通量血液透析(HFHD),高通量血液透析串联血液灌洗(HFHD+HP)治疗,治疗6个月,比较三组患者临床疗效,治疗前后微炎症指标,生活质量及并发症发生情况。结果:治疗6个月后,三组患者ALB和Kt/V显著高于治疗前(P<0.05),从A到C组依次升高(P<0.0125),BUN、Scr、β2-MG、PTH、CRP、IL-10、Hcy及TNF-a水平显著低于治疗前(P<0.05),从A到C组依次降低(P<0.0125);三组患者治疗后并发症发生情况有统计学差异(P<0.05),其中A组并发症发生率高于C组(30.00%vs.3.33%,P<0.0125);治疗后,三组患者SF-36和KDTA评分显著高于治疗前(P<0.05),从A到C组依次升高(P<0.0125)。结论:HFHD+HP透析方案能有效抑制终末期肾病患者炎症水平,提高生活质量,值得临床优先选用。Objective:To explore the correlation of quality of life,dialysis mode,efficacy and microinflammation index in maintaining dialysis patients.Methods:From January 2018 to January 2019,90 patients with end-stage renal disease who underwent dialysis in our hospital were randomly divided into three groups:A,B and C.Each group consisted of 30 patients.They were treated with hemodiafiltration(HDF),high-flux hemodialysis(HFHD)and high-flux hemodialysis combined with hemoperfusion(HFHD+HP).6 months after treatment,the clinical efficacy,microinflammation index,quality of life and complications of the three groups were compared before and after treatment.Results:After 6 months of treatment,ALB and Kt/V in the three groups were significantly higher than those before treatment(P<0.05),and increased from group A to group C in turn(P<0.0125),BUN,Scr,β2-MG,PTH,CRP,IL-10,Hcy and TNF-a levels were significantly lower than those before treatment(P<0.05),and decreased from group A to group C in turn(P<0.0125);There was statistical difference in the incidence of complications after treatment among the three groups(P<0.05),and the incidence of complications in group A was higher than that in group C(30.00%vs.3.33%,P<0.0125);After treatment,the SF-36 and KDTA scores in the three groups were significantly higher than those before treatment(P<0.05),and increased from group A to group C(P<0.0125).Conclusion:Compared with HDF and HFHD,dialysis with HFHD and HP in series can significantly improve the clinical efficacy,control the level of inflammation and improve the quality of life,and the safety is guaranteed.

关 键 词：终末期肾病 血液净化 微炎症 

分 类 号：R47[医药卫生—护理学]