高通量血液透析和低通量血液透析治疗尿毒症的效果比较  

Comparison of Clinical Effect of High Flux Hemodialysis and Low Flux Hemodialysis for Treatment of Uremia

作　　者：宛家奎[1] 水润芝[1] 李金玉[1] 章凌云[1] 汪成军[1] 王群鸥 叶茵[1] 邵珏[1] WAN Jiakui;SHUI Runzhi;LI Jinyu;ZHANG Lingyun;WANG Chengjun;WANG Qun′ou;YE Yin;SHAO Jue(Department of Blood Purification,Huangshan City People′s Hospital,Huangshan 245000,China)

机构地区：[1]黄山市人民医院血液净化科,安徽黄山245000

出　　处：《医学综述》2022年第5期1036-1040,共5页Medical Recapitulate

摘　　要：目的比较高通量血液透析(HFHD)和低通量血液透析(LFHD)治疗尿毒症的效果。方法选择2020年6—7月在黄山市人民医院行维持性血液透析治疗的60例慢性肾衰竭尿毒症患者为研究对象,按照治疗方法不同分为对照组和观察组,各30例。对照组采用LFHD,观察组采用HFHD,两组均治疗3个月。比较两组患者治疗前后肾功能相关指标[血清肌酐(Scr)、尿素氮(BUN)、全段甲状旁腺激素(iPTH)、β_(2)微球蛋白(β_(2)-MG)、钙、磷水平],炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)],血红蛋白(Hb)、白蛋白(Alb)水平,以及并发症发生情况。结果两组治疗前Scr、BUN、iPTH、β_(2)-MG、钙、磷水平比较差异无统计学意义(P>0.05),治疗后观察组iPTH、β_(2)-MG、钙、磷水平低于对照组(均P<0.01);治疗后,两组患者CRP和IL-6均低于治疗前(均P<0.05),且观察组低于对照组(P<0.01);Hb、Alb均高于治疗前(均P<0.05),且观察组高于对照组(P<0.01)。治疗期间两组消化道症状发生率比较差异无统计学意义(P>0.05),但观察组患者皮肤瘙痒、肾性骨营养不良和不安腿综合征发生率明显低于对照组[10.0%(3/30)比26.7%(8/30),6.7%(2/30)比20.0%(6/30),13.3%(4/30)比30.0%(9/30)](χ^(2)=5.234,P=0.021;χ^(2)=5.038,P=0.023;χ^(2)=4.937,P=0.024)。结论HFHD有助于改善维持性血液透析患者肾功能,降低患者并发症的发生率。Objective To compare the effects of high flux hemodialysis(HFHD)and low flux hemodialysis(LFHD)in the treatment of uremia.Methods A total of 60 patients with uremia with chronic renal failure who underwent maintenance hemodialysis in Huangshan City People′s Hospital from June to July 2020 were included,and were divided into a control group and an observation group according to the treatment method,with 30 cases in each group.The control group was treated with LFHD and the observation group was treated with HFHD.Both groups were treated for 3 months.The renal function indexes serum creatinine(Scr),blood urea nitrogen(BUN),intact parathyroid hormone(iPTH),β_(2)-microglobulin(β_(2)-MG),calcium and phosphorus level],inflammatory factors[C-reaction protein(CRP),interleukin-6(IL-6)],hemoglobin(Hb),and albumin(Alb)of the two groups before and after treatment,as well as complications,were compared.Results There was no significant difference in Scr,BUN,iPTH,β_(2)-MG,calcium and phosphorus level)between the two groups before treatment(P>0.05),and thelevels of iPTH,β_(2)-MG,calcium and phosphorus in the observation group were significantly lower than those in the control group after treatment(P<0.01).After treatment,CRP and IL-6 in the two groups were lower than those before treatment(all P<0.05),and the observation group′s indexes were lower than those in the control group(P<0.01);Hb and Alb were higher than those before treatment(all P<0.05),and the observation group′s indexes were higher than those in the control group(P<0.01).There was no significant difference in the incidence of gastrointestinal symptoms between the two groups during treatment(P>0.05),but the incidences of skin pruritus,renal osteodystrophy and restless leg syndrome in the observation group was significantly lower than those in the control group[10.0%(3/30)vs 26.7%(8/30),6.7%(2/30)vs 20.0%(6/30),13.3%(4/30)vs 30.0%(9/30)](χ^(2)=5.234,P=0.021;χ^(2)=5.038,P=0.023;χ^(2)=4.937,P=0.024).Conclusion HFHD is helpful to improve renal function and

关 键 词：尿毒症 维持性血液透析 高通量透析 低通量透析 

分 类 号：R459.5[医药卫生—治疗学]