尿毒症患者血液透析充分性与肺功能相关性研究  

Correlation Between Hemodialysis Adequacy and Pulmonary Function in Uremic Patients

作　　者：李宁 姚筱 郭芬 梁建忠 曾庆义 LI Ning;YAO Xiao;GUO Fen;LIANG Jianzhong;ZENG Qingyi(Department of Nephrology,Huizhou Third People Hospital/Huizhou Hospital Affiliated to Guangzhou Medical University,Huizhou Guangdong 516001,China)

机构地区：[1]惠州市第三人民医院/广州医科大学附属惠州医院肾内科,广东惠州516001

出　　处：《中国卫生标准管理》2020年第8期18-20,共3页China Health Standard Management

基　　金：惠州市医疗卫生类科技计划项目(2017Y156)。

摘　　要：目的观察尿毒症患者血液透析充分性与肺功能相关性,为临床慢性肾脏病患者肺功能治疗提供方法。方法选择本院维持性血液透析患者79例,以血压、尿素氮清除指数(Kt/v)、血清白蛋白、血红蛋白、血清钙磷甲状旁腺素水平评估血液透析充分性,多次分别测定用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、50%及25%用力肺活量的呼气流量(MEF50、MEF25)、一氧化碳弥散量(DLco)、一氧化碳弥散常数(DLco/VA)、一氧化碳弥散吸收率(DLco%)等肺功能指标,与慢性肾脏病(chronic kidney disease,CKD)5期患者肺功能比较。结果不充分透析组患者肺功能较CKD5期改善,差异具有统计学意义(P<0.05);充分透析组患者肺功能则显著改善,差异具有统计学意义(P<0.01);充分透析组较非充分透析组患者肺功能好转,差异具有统计学意义(P<0.05)。结论充分透析是改善尿毒症患者肺功能有效治疗手段,可作为维持性血液透析患者透析充分性评估指标之一。[Absttract]Objective To observe the correlation between hemodialysis adequacy and lung function in patients with uremia,and to provide a method for pulmonary function treatment in patients with chronic kidney disease.Methods We selected 79 patients with maintenance hemodialysis in our hospital,and evaluated the hemodialysis adequacy with blood pressure,urea clearance index(Kt/v),serum albumin,hemoglobin,serum calcium phosphate parathyroid hormone level,and determined lung function indicators several times such as the forced vital capacity(FVC),forced expiratory volumein the first second(FEV1),maximal expiratory flow at 50%of forced vital capacity,maximal expiratory flow at 25%of forced vital capacity,diffusion capacity of carbon monoxide,diffusion capacity for carbon monoxide per liter of alveolar volume,diffusion capacity of carbon monoxide absorption rate,compare lung function with patients of chronic kidney disease stage 5.Results The lung function of patients with inadequate dialysis group was improved compared with CKD stage 5(P<0.05).The lung function of patients with adequate dialysis group was significantly improved,the difference was statistically significant(P<0.01);The lung function of the patients in the dialysis group improved,and the difference was statistically significant(P<0.05).Conclusion Full dialysis is an effective treatment for improving lung function in patients with uremia,and can be used as one of the indicators for dialysis adequacy assessment in maintenance hemodialysis patients.

关 键 词：慢性肾脏病 尿毒症 维持性血液透析 血液透析充分性 尿素氮清除指数(Kt/v) 肺功能 

分 类 号：R692[医药卫生—泌尿科学]