血液灌流串联血液透析对尿毒症患者微炎状态和心脑血管事件的影响分析  

Effect of hemoperfusion and hemodialysis on microinflammation and cardiovascular and cerebrovascular events in uremic patients

作　　者：王奕[1] 王朝霞[2] 马世兴[2] 张焕巧[2] Wang Yi;Wang Zhaoxia;Ma Shixing(Teaching and Research Office of Baoji Vocational and Technical College,Baoji 721013,China)

机构地区：[1]宝鸡职业技术学院教研室,721013 [2]宝鸡市中心医院肾病糖尿病科

出　　处：《中华保健医学杂志》2020年第2期173-175,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨血液灌流串联血液透析对尿毒症患者微炎状态和心脑血管事件的影响。方法选取宝鸡市中心医院2016年12月~2018年10月收治的尿毒症患者60例,依据随机数表法分为单纯血液透析(Hemodialysis,HD)组和血液灌流串联血液透析(Hemoperfusion tandem hemodialysis,HP+HD)组,每组30例,HD组给予血液透析治疗,HP+HD组血液灌流串联血液透析治疗。比较两组治疗前后血清炎症因子水平,统计比较治疗后两组的并发症、6个月内心脑血管事件和1年后死亡率。结果治疗后,HP+HD组患者血清炎症因子水平低于HD组,差异有统计学意义(P <0.05);而HD组患者血清炎症因子与治疗前相近,差异无统计学意义(P> 0.05);HP+HD组治疗后的心脑血管发生率明显低于HD组,差异具有统计学意义(P <0.05)。随访1年后,HP+HD组死亡率明显低于HD组,差异有统计学意义(P <0.05)。结论相较于单纯血液透析,血液透析与血液灌流串联能够有效改善尿毒症患者的炎症水平,降低心脑血管的发生和死亡率,值得临床推广。Objective To discuss the effect of hemoperfusion and hemodialysis on microinflammation and cardiovascular and cerebrovascular events in uremic patients.Methods 60 patients with uremia were selected from December 2016 to October 2018 in our hospital.According to the random distribution,all patients were divided into simple hemodialysis(HD)group and hemoperfusion series hemodialysis(HP + HD)group.There were 30 cases in each group.The patients in HD group were treated with hemodialysis,and the patients in HP + HD group were treated with hemoperfusion and hemodialysis in series.The levels of serum inflammatory factors before and after treatment were compared between the two groups, and the complications, 6-month cardiovascular events and 1-year mortality were statistically compared between the two groups.Results After treatment,serum inflammatory cytokines in the HP+HD group were lower than those in the HD group,and the difference was statistically significant(P < 0.05).The serum inflammatory factors in the HD group were similar to those before treatment,with no significant difference(P > 0.05).The incidence of cardiovascular and cerebrovascular disease in HP + HD group was significantly lower than that in HD group,the difference was statistically significant(P <0.05).Following up for 1 year,the mortality of HP +HD group was significantly lower than that of HD group(P < 0.05).Conclusion Compared with simple hemodialysis,hemodialysis and hemoperfusion in series can effectively decrease the level of inflammation in uremic patients,reduce the incidence and mortality of cardiovascular and cerebrovascular disease,which is worthy of clinical promotion.

关 键 词：血液灌流 血液透析 尿毒症 微炎状态 心脑血管事件 

分 类 号：R692.5[医药卫生—泌尿科学]