不同频次的血液透析滤过对尿毒症患者瘦素水平变化与改善营养状态的影响  

Effect of the Change of Leptin Level and Improvement of Nutritional Status in Patients with Uremia with Different Frequency of Hemodiafiltration

作　　者：谭艳杰 纪镇华[1] 郑华[1] 孙艺[1] 郭鑫鑫 TAN Yanjie;JI Zhenhua;ZHENG Hua;YI Sun;GUO Xinxin(Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,China)

机构地区：[1]沈阳医学院附属中心医院,辽宁沈阳110024

出　　处：《中国医药指南》2023年第5期78-80,共3页Guide of China Medicine

基　　金：沈阳医学院科技基金(20171019)。

摘　　要：目的 探讨不同频次血液透析滤过对尿毒症患者瘦素水平、营养状态的影响。方法 选取2018年1月至2019年12月在沈阳医学院附属中心医院行血液透析治疗的患者90例,根据不同的治疗方法将其分为血液透析组(HD组)、血液透析滤过A组(HDF A组)、血液透析滤过B组(HDF B组),于首次血液净化治疗前及3个月试验结束后下一次血液透析前检测患者瘦素、血红蛋白(HGB)、血清白蛋白(Alb)、前白蛋白(PA)、总胆固醇(CHOL)、肌酐(Scr)、尿素氮(BUN),应用主观综合性营养状况评估表(PG-SGA)评估患者的营养状态。结果 与透析前比较,透析3个月后,HDF A组、HDF B组患者血标本中瘦素水平均降低,但HDF B组水平更低,差异有统计学意义(P<0.05);治疗3个月后,与HD组比较HDF B组血瘦素水平明显下降,差异有统计学意义(P<0.05);治疗3个月后,HDF组、HDF A组、HDF B组的营养质量评分均优于治疗前,且HDF B组较HDF A组更明显,差异有统计学意义(P<0.05)。结论 对尿毒症患者采用每周3次血液透析滤过能够更好地降低血液中瘦素,改善患者的营养状态。Objective To investigate the effect of different frequency of hemodiafiltration on leptin level and nutritional status in patients with uremia. Methods Selection in the Center of Shenyang Medical School Affiliated Hospital in January 2018 to December 2019 line hemodialysis treatment, 90 cases of patients, according to the different methods of treatment will be divided into hemodialysis(HD), hemodialysis filtration(HDF)in group A, group A hemodialysis filtration(HDF) group B, group B prior to the first blood purification treatment and 3 months after the test next time before hemodialysis patients leptin, hemoglobin(HGB), serum albumin(propagated) and prealbumin(PA), total cholesterol(CHOL), creatinine(Scr), urea nitrogen(BUN), The nutritional status of patients was assessed using the subjective comprehensive nutritional status assessment form(PG-SGA). Results Compared with that before dialysis, after 3 months of dialysis, the leptin level in blood samples of patients in HDF A group and HDF B group decreased, but the level in HDF B group was lower, the difference was statistically significant(P<0.05). After 3 months of treatment, the serum leptin level of HDF group B decreased significantly compared with that of HD group(P<0.05). After 3 months of treatment,the nutritional quality scores of HDF group, HDF A group and HDF B group were better than those before treatment, and HDF B group was more obvious than that in HDF A group, and the difference was statistically significant(P<0.05). Conclusion Hemodiafiltration three times a week can better reduce the leptin in the blood and improve the nutritional status of patients with uremia.

关 键 词：尿毒症 血液透析 血液净化 瘦素 

分 类 号：R692.3[医药卫生—泌尿科学]