血液灌流联合血液透析对肾衰竭伴钙磷代谢异常患者的影响  

Effect of Hemoperfusion Combined with Hemodialysis on Renal Failure Patients with Abnormal Calcium and Phosphorus Metabolism

作　　者：黄荣辉 HUANG Ronghui(Longyan Bo’ai Hospital,Longyan 364000,China)

机构地区：[1]龙岩市博爱医院,福建龙岩364000

出　　处：《中外医学研究》2023年第10期35-38,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨血液灌流联合血液透析对肾衰竭伴钙磷代谢异常患者的影响。方法:选择龙岩市博爱医院2021年1月—2022年1月收治的91例肾衰竭伴钙磷代谢异常患者,按照随机数表法分为A组(n=46)和B组(n=45),B组予以血液透析治疗,A组在B组基础上予以血液灌流治疗,观察两组肾功能指标[β_(2)-微球蛋白(β_(2)-MG)、血肌酐(Scr)、尿酸(UA)]、钙磷代谢水平、甲状旁腺素(PTH)水平及炎症反应[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)]。结果:治疗前,两组β_(2)-MG、Scr、UA水平比较,差异无统计学意义(P>0.05);治疗3个月后,两组β_(2)-MG、Scr、UA水平均较治疗前降低,且A组低于B组,差异有统计学意义(P<0.05)。治疗前,两组血钙、血磷水平比较,差异无统计学意义(P>0.05);治疗3个月后,两组血钙水平较治疗前升高,血磷水平较治疗前降低,且A组血钙水平高于B组,血磷水平低于B组,差异有统计学意义(P<0.05)。A组血钙达标率(80.43%)、血磷达标率(65.22%)高于B组(55.56%、40.00%),差异有统计学意义(P<0.05)。治疗前,两组PTH水平比较,差异无统计学意义(P>0.05);治疗3个月后,两组PTH水平均较治疗前降低,且A组低于B组,差异有统计学意义(P<0.05)。A组PTH达标率(52.17%)高于B组(26.68%),差异有统计学意义(P<0.05)。治疗前,两组hs-CRP、IL-6、TNF-α水平比较,差异无统计学意义(P>0.05),治疗3个月后,两组hs-CRP、IL-6、TNF-α水平均较治疗前降低,且A组低于B组,差异有统计学意义(P<0.05)。结论:血液灌流联合血液透析有助于改善肾衰竭伴钙磷代谢异常患者的肾功能,维持钙磷代谢平衡,降低PTH水平,减轻炎症反应。Objective:To investigate the effect of hemoperfusion combined with hemodialysis on renal failure patients with abnormal calcium and phosphorus metabolism.Method:A total of 91 patients with renal failure associated with calcium and phosphorus metabolism admitted in Longyan Bo’ai Hospital from January 2021 to January 2022,and they were divided into the group A(n=46)and group B(n=45)according to random number table.Group B was treated with hemodialysis,while group A was treated with hemoperfusion on the basis of group B.The renal function indexes of the two groups[β_(2)-microglobulin(β_(2)-MG),serum creatinine(Scr),uric acid(UA)],calcium and phosphorus metabolism level,parathyroid hormone(PTH)level and inflammatory response[hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]were observed.Result:Before treatment,there were no significant differences in the levels ofβ_(2)-MG,Scr and UA between the two groups(P>0.05);after 3 months of treatment,the levels ofβ_(2)-MG,Scr and UA in the two groups were lower than those before treatment,and the indexes in group A were lower than those in the group B,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences between the two groups in blood calcium and phosphorus levels(P>0.05);after 3 months of treatment,the blood calcium levels of the two groups were higher than those before treatment,and the blood phosphorus levels were lower than those before treatment,and the blood calcium level of group A was higher than that of group B,and the blood phosphorus level was lower than that of group B,the differences were statistically significant(P<0.05).The rate of reaching the standard of blood calcium(80.43%)and blood phosphorus(65.22%)in group A were higher than those in group B(55.56%,40.00%),the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in PTH level between the two groups(P>0.05);after 3 months of treatment,the PTH levels

关 键 词：肾衰竭 钙磷代谢异常 血液灌流 血液透析 甲状旁腺激素 炎症反应 

分 类 号：R692.5[医药卫生—泌尿科学] R589.5[医药卫生—外科学]