高通量血液透析对终末期肾衰竭患者微炎症状态、钙磷代谢及肾功能的影响  

Effects of high-flux hemodialysis on microinflammatory state,calcium and phosphorus metabolism and renal function in patients with end-stage renal failure

作　　者：程高飞 蔡香香 CHENG Gao-fei;CAI Xiang-xiang(Department of Nephrology,Xianyang Hospital of Yan'an University,Yan'an 712000,Shaanxi,CHINA)

机构地区：[1]延安大学咸阳医院肾病学科,陕西延安712000

出　　处：《海南医学》2021年第18期2341-2344,共4页Hainan Medical Journal

摘　　要：目的探讨高通量血液透析(HFHD)和低通量血液透析(LFHD)对终末期肾衰竭(ESRF)患者微炎症状态、钙磷代谢及肾功能的影响。方法选择2018年7月至2020年7月延安大学咸阳医院肾病学科收治的80例ESRF患者为研究对象,采用随机数表法将患者分为观察组和对照组,每组40例。对照组给予LFHD治疗,观察组给予HFHD治疗。治疗6个月后,比较两组患者的钙磷代谢、C反应蛋白(CRP)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、尿素氮(BUN)、血肌酐(Scr)水平和并发症发生情况。结果治疗后,两组患者的钙、磷代谢水平均降低,且观察组[(1.58±0.34)mmol/L、(1.21±0.21)mmol/L]明显低于对照组[(2.23±0.31)mmol/L、(1.67±0.33)mmol/L],差异均有统计学意义(P<0.05);治疗后,两组患者的CRP、TNF-α、IL-6表达水平均升高,但观察组[(10.13±2.19)mg/L、(15.89±3.51)ng/L、(7.10±1.65)ng/L]明显低于对照组[(13.21±2.16)mg/L、(18.45±2.90)ng/L、(8.89±1.72)ng/L],差异均有统计学意义(P<0.05);治疗后,两组患者的BNU、Scr水平比较差异均无统计学意义(P>0.05);观察组患者的并发症发生率为5.0%,明显低于对照组的22.5%,差异有统计学意义(P<0.05)。结论HFHD治疗ESRF可有效调节患者的钙磷代谢水平,改善微炎症状态和肾功能状态,且并发症少,建议临床推广应用。Objective To investigate the effects of high-flux hemodialysis(HFHD)and low-flux hemodialysis(LFHD)on the microinflammation state,calcium and phosphorus metabolism,and renal function in patients with end-stage renal failure(ESRF).Methods A total of 80 ESRF patients admitted to the Xianyang Hospital of Yan'an Uni-versity from July 2018 to July 2020 were selected as the research objects,and the patients were divided into an observa-tion group and a control group by random number table method,with 40 patients in each group.The control group was treated with LFHD,and the observation group was given HFHD.After 6 months of treatment,the calcium and phos-phorus metabolism were compared between the two groups,as well as the levels of C-reactive protein(CRP),serum tu-mor necrosis factor-α(TNF-α),interleukin-6(IL-6),urea nitrogen(BUN),serum creatinine(SCR)and complica-tions.Results After treatment,the levels of calcium and phosphorus metabolism decreased in the two groups,both of which were significantly lower in the observation group with(1.58±0.34)mmol/L and(1.21±0.21)mmol/L than in the control group with(2.23±0.31)mmol/L and(1.67±0.33)mmol/L,and the differences were statistically significant(P<0.05).After treatment,the expression levels of CRP,TNF-αand IL-6 increased in the two groups,all of which were sig-nificantly lower in the observation group[(10.13±2.19)mg/L,(15.89±3.51)ng/L,(7.10±1.65)ng/L]than in the control group[(13.21±2.16)mg/L,(18.45±2.90)ng/L,(8.89±1.72)ng/L],and the differences were statistically significant(P<0.05).After treatment,there was no statistically significant difference in the levels of BNU and Scr between the two groups(P>0.05).The complication rate of the observation group was 5.0%,which was significantly lower than 22.5%of the control group(P<0.05).Conclusion HFHD treatment for ESRF patients can effectively regulate the levels of calci-um and phosphorus metabolism,improve the state of microinflammation and renal function,and has fewer complica-tions.Therefore,it is recommended fo

关 键 词：终末期肾衰竭 高通量血液透析 炎症状态 钙磷代谢 肾功能 并发症 

分 类 号：R692.5[医药卫生—泌尿科学]