血液灌流与血液透析联合治疗对尿毒症透析效率、脂代谢和动脉粥样硬化的影响研究  

Study on the Effect of Combined Treatment of Hemoperfusion and Hemodialysis on Dialysis Efficiency,Lipid Metabolism and Atherosclerosis in Uremic Patients

作　　者：何明 李拔敏 杨春东 HE Ming;LI Bamin;YANG Chundong(The Second Department of Nephrology,Gaozhou People's Hospital of Guangdong Province,Gaozhou,Guangdong Province,525200 China)

机构地区：[1]广东省高州市人民医院肾内二科,广东高州525200

出　　处：《中外医疗》2021年第17期4-6,共3页China & Foreign Medical Treatment

摘　　要：目的通过病例对比分析探讨血液灌流与血液透析联合方案在尿毒症治疗中的临床价值。方法随机抽取2015年1月—2019年12月该院科室收治的65例符合研究要求的尿毒症患者进行对照研究,根据治疗方案将其中34例接受血液灌流和血液透析联合治疗的患者作为研究组,另31例单纯接受血液透析治疗的患者作为对照组,比较两组患者的治疗效果。结果治疗后6个月,研究组患者的肾功能各项指标[血尿素氮(BUN)(15.62±1.52)μmol/L、肌酐(Scr)(319.76±36.13)μmol/L、β2-微球蛋白(β2-MG)(23.70±2.35)mg/L以及血尿酸(BUA)(355.78±39.59)μmol/L]均低于对照组,组间对比差异有统计学意义(t=10.254、13.062、8.308、12.879,P<0.05);脂代谢指标[三酰甘油(TG)、总胆固醇(TC)以及载脂蛋白]均低于对照组,差异有统计学意义(P<0.05);研究组患者的颈动脉超声定量参数灰阶中位数值、增强强度和密度均优于对照组,差异有统计学意义(P<0.05)。结论血液灌流联合血液透析治疗尿毒症的整体临床效果优于单纯血液透析治疗,建议在临床中优先应用。Objective To investigate the clinical value of combined hemoperfusion and hemodialysis in the treatment of uremia through comparative analysis of cases.Methods 65 patients of the hospital with uremia who were admitted to the department from January 2015 to December 2019 were randomly selected for a controlled study.According to the treatment plan,34 patients who received combined hemoperfusion and hemodialysis were used as the research group.Thirty-one patients who received only hemodialysis treatment served as a control group to compare the treatment effects of the two groups.Results 6 months after the treatment,statistics showed that the renal function indicators of the patients in the study group[blood urea nitrogen(BUN)(15.62±1.52)μmol/L,creatinine(Scr)(319.76±36.13)μmol/L,β2-microglobulin(β2-MG)(23.70±2.35)mg/L and blood uric acid(BUA)(355.78±39.59)μmol/L]were lower than the control group,and the difference between the groups was statistically significant(t=10.254,13.062,8.308,12.879,P<0.05);metabolic indicators[triglyceride(TG),total cholesterol(TC)and apolipoprotein indicators]were lower than the control group,the difference was statistically significant(P<0.05);the study group patients’carotid artery ultrasound quantitative parameters gray-scale median value and enhanced intensity and density were better than those of the control group,the difference was statistically significant(P<0.05).Conclusion The overall clinical effect of hemoperfusion combined with hemodialysis in the treatment of uremia is better than that of hemodialysis alone,and it is recommended that it should be used in clinical practice.

关 键 词：尿毒症 血液灌流 血液透析 脂代谢 动脉粥样硬化 

分 类 号：R692.5[医药卫生—泌尿科学]