内源性再输注血液透析滤过在血液透析不宁腿综合征中的应用  

Application of hemodiafiltration with endogenous reinfusion in hemodialysis restless legs syndrome

作　　者：姜小梅[1] 刘鹏程 马琴 曾颖[2] 沈明敬[3] 高卢燕 宋锴[2] JIANG Xiaomei;LIU Pengcheng;MA Qin;ZENG Ying;SHEN Mingjing;GAO Luyan;SONG Kai(Blood Purification Center,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215004,China;Department of Nephrology,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215004,China;Department of Thoracic Surgery,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215004,China)

机构地区：[1]苏州大学附属第二医院血液净化中心,江苏苏州215004 [2]苏州大学附属第二医院肾内科,江苏苏州215004 [3]苏州大学附属第二医院胸外科,江苏苏州215004

出　　处：《重庆医学》2022年第4期563-568,共6页Chongqing medicine

基　　金：国家自然科学基金项目(81802989);苏州市“科教兴卫”青年科技项目(KJXW2020017)。

摘　　要：目的观察内源性再输注血液透析滤过(HFR)对缓解尿毒症行血液透析患者尿毒症不宁腿综合征(URLS)的治疗效果。方法选择2020年6月1日至10月31日于该院接受维持性血液透析的URLS患者7例,行临床前后对照研究。尿毒症患者行HFR治疗两次,比较HFR治疗前后不宁腿综合征(RLS)严重程度、睡眠质量、生活质量和相关实验室检查指标的变化。结果与治疗前相比,HFR治疗后患者血清尿素氮、肌酐、尿酸、磷、胱抑素-C、β_(2)-微球蛋白(β_(2)-MG)、同型半胱氨酸水平均下降,差异有统计学意义(P<0.05);患者RLS严重程度评分、匹茨堡睡眠质量指数量表评分、欧洲五维度健康状况生活质量量表评分均下降,差异有统计学意义(P<0.05)。结论HFR治疗短期内能较快降低血清β_(2)-MG水平,改善尿毒症患者RLS症状,提高睡眠质量及生活质量。Objective To observe the effect of hemodiafiltration with endogenous reinfusion(HFR)on uremic restless legs syndrome(URLS)in patients undergoing hemodialysis to relieve uremia.Methods A total of seven patients with URLS who received maintenance hemodialysis in this hospital from 1 June 2020 to 31 October 2020 were selected.A pre-and post-clinical controlled study was performed.Uremia patients were treated with HFR twice,the changes in the severity of restless legs syndrome(RLS),sleep quality,quality of life and related laboratory test indicators were observed.Results After HFR treatment,the serum levels of urea nitrogen,creatinine,uric acid,phosphorus,cystin-C and β_(2)-microglobulin(β_(2)-MG),homocysteine were lower than those before treatment,and there were statistically significant differences(P<0.05).Similarly,the RLS severity score,Pittsburgh Sleep Quality Index Scale score and European Quality of Life Five-Dimension Scale score were significantly decreased compared with those before HFR treatment,and there were statistically significant differences(P<0.05).Conclusion In a short period,HFR treatment can rapidly reduce serum level ofβ_(2)-MG,improve RLS symptoms,and improve quality of sleep and life in patients with uremia.

关 键 词：不宁腿综合征 内源性再输注血液透析滤过 血液透析 实验室检查 睡眠质量 生活质量 

分 类 号：R692.5[医药卫生—泌尿科学] R744.8[医药卫生—外科学]