血液透析联合血液灌流治疗尿毒症对患者残余肾功能及血清肌酐、β2-MG水平的影响  

Effects of hemodialysis combined with hemoperfusion on residual renal function and serum creatinine and β2-MG in patients with uremia

作　　者：覃源 曾凝[2] 李莉 李康慧[2] 韦家智[2] QIN Yuan;ZENG Ning;LI Li(Department of Nephrology,Guilin People's Hospital,Guilin Guangxi 541002,China;Department of Nephrology,Affiliated Hospital of Guilin Medical College,Guilin Guangxi 541001,China)

机构地区：[1]桂林市人民医院肾内科,广西桂林541002 [2]桂林医学院附属医院肾内科,广西桂林541001

出　　处：《临床和实验医学杂志》2022年第10期1064-1067,共4页Journal of Clinical and Experimental Medicine

基　　金：广西自然科学基金面上项目(编号:2018GXNSFAA138119)。

摘　　要：目的探讨与分析血液透析联合血液灌流治疗尿毒症对患者残余肾功能及血清肌酐、β2-微球蛋白(β2-MG)水平的影响。方法回顾性选择2018年11月到2021年7月在桂林市人民医院诊治的尿毒症患者95例作为研究对象,根据治疗方法不同将其分为联合组(n=48)与对照组(n=47)。对照组给予血液透析治疗,联合组血液透析联合血液灌流治疗,治疗4周后,检测患者残余肾功能及血清肌酐、β2-MG水平变化情况;观察并记录两组患者在治疗期间出现的导管相关性感染发生情况以及治疗4周后的急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)情况与死亡情况;采用生活质量综合评定量表(GQOL-74)对其生活质量进行评估。结果与治疗前相比,治疗4周后两组血清肌酐水平与β2-MG水平明显降低,且与对照组相比,联合组血清肌酐、β2-MG水平显著降低,差异均有统计学意义(P<0.05)。联合组与对照组治疗期间的导管相关性感染发生率分别为4.2%和2.1%,组间对比差异无统计学意义(P>0.05)。治疗前,两组APACHEⅡ评分差异无统计学意义(P>0.05);与治疗前相比,治疗4周后两组APACHEⅡ评分均显著增加,且与对照组相比,治疗4周后联合组的APACHEⅡ评显著增加,差异均有统计学意义(P<0.05)。治疗4周后,联合组患者的生活质量评分(社会功能、物质生活、躯体健康、心理健康等)评分较对照组高,差异均有统计学意义(P<0.05)。结论血液透析联合血液灌流可降低尿毒症患者血清肌酐、β2-MG水平,改善尿毒症者的残余肾功能,提高APACHEⅡ评分与生活质量。Objective To investigate and analysis the effects of hemodialysis combined with hemoperfusion on residual renal function and serum creatinine andβ2-microglobulin(β2-MG)in patients with uremia.Methods A total of 95 patients with uremia who were diagnosed and treated in Guilin People's Hospital from November 2018 to July 2021 were retrospectively selected as the research subjects.According to different treatment methods,they were divided into a combination group(n=48)and a control group(n=47).The control group were treated with hemodialysis,and the combination group were treated with hemodialysis and hemoperfusion.The treatment observation time were 4 weeks.The residual renal function and serum creatinine andβ2-MG level changes.The occurrence of catheter-related infection during treatment,APACHE II score and death after 4 weeks of treatment were observed and recorded in the two groups;the quality of life was assessed by GQOL-74.Results Compared with before treatment,serum creatinine levels andβ2-MG levels in the two groups after 4 weeks of treatment were significantly lower,and compared with the control group,the combined group was significantly lower,the differences were statistically significant(P<0.05).The incidence of catheter-related infection in the combination group group and the control group were 4.2%and 2.1%respectively.There were no significant difference compared between the two groups(P>0.05).There was no significant difference in APACHEⅡscore between the two groups before treatment(P>0.05);compared with before treatment,the APACHEⅡscores of the two groups were significantly increased after 4 weeks of treatment,and compared with the control group,the APACHEⅡscores of the combined group were significantly increased after 4 weeks of treatment,the differences were statistically significant(P<0.05).After 4 weeks of treatment,the scores of material life,social function,mental health and physical health of the survivors in the combination group were higher than those in the control group,the differ

关 键 词：尿毒症 血液透析 血液灌流 残余肾功能 肌酐 Β2-微球蛋白 急性生理与慢性健康Ⅱ评分 

分 类 号：R692.5[医药卫生—泌尿科学]