血液透析和血液透析滤过对尿毒症患者体内毒素清除效果的比较  

Comparison of toxin removal effect between hemodialysis and hemodiafiltration in uremia patients

作　　者：梁建忠[1] 郭芬 林彩花 LIANG Jianzhong;GUO Fen;LIN Caihua(The Third People’s Hospital of Huizhou,Huizhou 516000)

机构地区：[1]惠州市第三人民医院,广东惠州516000

出　　处：《当代医药论丛》2022年第1期54-56,共3页

基　　金：血液透析和血液透析滤过对慢性肾衰竭尿毒症患者体内毒素清除效果比较及应用研究,惠州市计划科技项目(项目编号:2020Y214)。

摘　　要：目的:比较对尿毒症患者进行血液透析和血液透析滤过对其体内毒素的清除效果。方法:将2020年1月至2021年6月期间惠州市第三人民医院收治的100例尿毒症患者作为研究对象。将其随机分为血液透析组和血液透析滤过组,每组50例患者。对血液透析组患者进行血液透析(3次/周),对血液透析滤过组患者进行血液透析(2次/周)+血液透析滤过(1次/周)。然后比较两组患者血尿素氮、血肌酐、血尿酸、血清磷、血清甲状旁腺激素、血清β_(2)微球蛋白的清除率、血浆白蛋白的水平和标准化蛋白分解代谢率。结果:1)治疗后,血液透析滤过组患者血肌酐、血尿素氮、血尿酸、血清磷的清除率均高于血液透析组患者,差异有统计学意义(P<0.05)。2)治疗后,血液透析滤过组患者血清β_(2)微球蛋白、血清甲状旁腺激素的清除率均高于血液透析组患者,差异有统计学意义(P<0.05)。3)治疗后,两组患者血浆白蛋白的水平相比,差异无统计学意义(P>0.05);血液透析滤过组患者的标准化蛋白分解代谢率高于血液透析组患者,差异有统计学意义(P<0.05)。结论:与进行血液透析相比,对尿毒症患者进行血液透析滤过的效果较好,可显著提高其血尿素氮、血肌酐、血尿酸、血清磷、血清甲状旁腺激素、血清β_(2)微球蛋白的清除率和标准化蛋白分解代谢率,且不会增加其发生营养不良的风险。Objective:To compare the effect of hemodialysis and hemodiafiltration on the elimination of toxins in uremia patients.Methods:A total of 100 patients with uremia admitted to the Third People’s Hospital of Huizhou from January 2020 to June 2021 were selected as the study subjects.They were randomly divided into hemodialysis group and hemodiafiltration group with 50 patients in each group.Patients in the hemodialysis group were treated with hemodialysis(3 times/week),and patients in the hemodiafiltration group were treated with hemodialysis(2 times/week)+hemodiafiltration(once per week).Then,the clearance rates of blood urea nitrogen,serum creatinine,serum uric acid,serum phosphorus,serum parathyroid hormone,serumβ_(2) microglobulin,plasma albumin level and standardized protein catabolism rate of 2 groups were compared.Results:1)After treatment,the clearance rates of serum creatinine,blood urea nitrogen,blood uric acid and serum phosphorus in hemodialysis group were higher than those in hemodialysis group,the differences were statistically significant(P<0.05).2)After treatment,the clearance rates of serumβ_(2) microglobulin and serum parathyroid hormone in hemodiafiltration group were higher than those in hemodialysis group,the differences were statistically significant(P<0.05).3)After treatment,there was no significant difference in plasma albumin level between 2 groups(P>0.05);The standardized protein catabolism rate in hemodiafiltration group was higher than that in hemodialysis group,the difference was statistically significant(P<0.05).Conclusion:compared with in hemodialysis,for patients with uremia hemodialysis filtration effect is good,can significantly improve the blood urea nitrogen,serum creatinine,blood uric acid,serum phosphorus,parathyroid hormone,serum beta 2 microglobulin clearance and standardized protein catabolic rate,and does not increase the risk of malnutrition.

关 键 词：血液净化 血液透析 血液透析滤过 尿毒症 毒素 清除 

分 类 号：R692.5[医药卫生—泌尿科学]