不同频率血液透析滤过联合高通量血液透析治疗尿毒症的效果分析及对预后的影响  

Effects of different frequency of hemodiafiltration combined with HFHD on clearance of uremic toxins and prognosis of uremia

作　　者：刘倩[1] 蒲萌萌 杨凯 霍鹏飞[2] 张风超 Liu Qian;Pu Meng-meng;Yang Kai;Huo Peng-fei;Zhang Feng-chao(Department of Nephrology,Xingtai People's Hospital,Xingtai,Hebei 054000,China;Hemopurification Center,Xingtai People's Hospital,Xingtai,Hebei 054000,China;Department of Emergency,Xingtai People's Hospital,Xingtai,Hebei 054000,China)

机构地区：[1]邢台市人民医院肾脏内科,河北邢台054000 [2]邢台市人民医院血液净化室,河北邢台054000 [3]邢台市人民医院急诊科,河北邢台054000

出　　处：《中国现代医学杂志》2023年第6期71-76,共6页China Journal of Modern Medicine

基　　金：河北省自然科学基金(No:2019865)。

摘　　要：目的分析不同频率血液透析滤过联合高通量血液透析(HFHD)对尿毒症血管相关分子物质清除及预后的影响。方法选取2016年7月—2021年7月在邢台市人民医院行血液透析的尿毒症患者122例为研究对象,随机分为对照组和研究组,每组61例。两组均给予血液透析滤过和HFHD治疗,HFHD治疗完全相同,但对照组血液透析滤过治疗1次/月,研究组血液透析滤过治疗1次/周。两组自治疗起始随访12个月。对比两组治疗前后血管相关分子物质清除情况、患者营养状况、炎症因子及肾功能,比较两组用药情况及近期预后。结果研究组治疗前后血钙、血磷、血钾的差值均高于对照组(P<0.05)。研究组治疗前后血红蛋白、血白蛋白、转铁蛋白的差值均高于对照组(P<0.05)。研究组治疗前后超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的差值均高于对照组(P<0.05)。研究组治疗前后血尿素氮、血肌酐、残余尿量的差值均高于对照组(P<0.05)。研究组治疗前后促红细胞生成素、静脉铁剂用量的差值均高于对照组(P<0.05)。两组总不良事件发生率比较,差异无统计学意义(P>0.05)。结论相对于1次/月血液透析滤过治疗,1次/周的血液透析滤过治疗联合HFHD能更有效地清除尿毒症患者血管相关分子物质,改善患者营养状况及肾功能,降低炎症因子,减少促红细胞生成素、静脉铁剂用量。Objective To analyze the effects of different frequency of hemodiafiltration combined with high flux hemodialysis(HFHD)on the clearance of uremic toxins and prognosis of uremia.Methods A total of 122patients with uremia who received hemodialysis in our hospital from July 2016 to July 2021 were selected and divided into the control group and the research group randomly,with 61 cases in each group.Both groups were given hemodiafiltration and HFHD treatment.The frequency of HFHD treatment was consistent between the two groups.In contrast,the control group was treated with hemodiafiltration once a month,while the study group was treated with hemodiafiltration once a week.The two groups were followed up for 12 months from the start of treatment.The clearance of uremic toxins,nutritional status,levels of inflammatory factors and renal function of the two groups before and after the treatment were compared.The drug use and short-term prognosis of the two groups were also compared.Results The differences of serum levels of calcium,phosphorus and potassium before and after the treatment in the study group were higher than those in the control group(P<0.05).The differences of the levels of hemoglobin,serum albumin and transferrin before and after the treatment in the study group were higher than those in the control group(P<0.05).The differences of the levels of high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)before and after the treatment in the study group were higher than those in the control group(P<0.05).The differences of the levels of blood urea nitrogen and serum creatinine and residual urine volume before and after the treatment in the study group were higher than those in the control group(P<0.05).The differences of the dosages of erythropoietin and intravenous iron before and after the treatment in the study group were higher than those in the control group(P<0.05).There was no significant difference in the overall incidence of adverse events between the two gro

关 键 词：尿毒症 血液透析滤过 频率 效果 

分 类 号：R692.5[医药卫生—泌尿科学]