不同血液净化方式治疗慢性肾衰竭尿毒症的效果比较  

Therapeutic effects of different blood purification methods on uremia patients with chronic renal failure

作　　者：荆燕 王静丽[1] 杨清柯 Jing Yan;Wang Jingli;Yang Qingke(Department of Blood Purification,Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第三附属医院血液净化科,郑州450000

出　　处：《中国实用医刊》2023年第14期61-64,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较不同血液净化方式治疗慢性肾衰竭(CRF)尿毒症的临床效果。方法抽取2021年2月至2022年2月河南中医药大学第三附属医院收治的CRF尿毒症患者100例,按照随机数字表法分为对照组与研究组,每组50例。对照组采用血液透析滤过(HDF)治疗,研究组采用高通量血液透析(HFHD)治疗。对比两组临床疗效、小分子毒素[血尿素氮(BUN)、血肌酐(Scr)、血磷]水平、大分子毒素[β2-微球蛋白(β2-MG)、半胱氨酸蛋白酶抑制剂C(Cys C)、全段甲状旁腺激素(iPTH)]水平、尿素透析指标[标准蛋白分解代谢率(nPCR)、时间平均尿素浓度(TACurea)、尿素清除指数(Kt/A)]及认知功能[P300波波峰潜伏期(PL)、波幅(Amp)]。结果研究组总有效率(94.00%,47/50)高于对照组(80.00%,40/50),P<0.05。治疗后,研究组治血磷水平[(1.51±0.14)μmmol/L]低于对照组[(1.96±0.21)μmmol/L],P<0.05;研究组β2-MG、Cys C、iPTH水平[(9.24±0.81)mg/L,(3.86±0.34)mg/L,(461.75±38.95)pg/ml]低于对照组[(9.88±0.95)mg/L,(5.23±0.49)mg/L,(526.39±49.71)pg/ml],P<0.05;研究组PL水平[(302.16±26.74)ms]低于对照组[(325.81±31.25)ms]、Amp水平[(9.38±0.92)μV]高于对照组[(8.19±0.81)μV],P<0.05;研究组nPCR、TACurea、Kt/A水平与对照组比较差异未见统计学意义(P>0.05)。结论HDF和HFHD均能在一定程度上清除CRF尿毒症患者体内的毒素,但与HDF相比,HFHD的疗效更好,能有效清除nPCR、TACurea、血磷等大分子和小分子毒素,改善患者认知功能。Objective To compare the clinical effects of different blood purification methods on uremia patients with chronic renal failure(CRF).Methods A total of 100 uremia patients with CRF treated in Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from February 2021 to February 2022 were selected as research objects,and they were divided into control group and study group according to random number table method,with 50 cases in each group.The control group was treated by hemodiafiltration(HDF),while the study group was treated by high-flux hemodialysis(HFHD).The clinical efficacy,small molecular toxins,including blood urea nitrogen(BUN),serum creatinine(Scr)and blood phosphorus,macromolecular toxins,includingβ2-microglobulin(β2-MG),cystatin C(Cys C)and intact parathyroid hormone(iPTH),urea dialysis indexes,including normalized protein catabolic rate(nPCR),time-averaged concentration of urea(TACurea)and urea clearance index(Kt/A),and cognitive function assessed by peak latency(PL)and amplitude(Amp)of the two groups were compared.Results The total effective rate of the study group(94.00%,47/50)was higher than that of the control group(80.00%,40/50),P<0.05.After treatment,the blood phosphorus level in the study group was(1.51±0.14)μmmol/L,lower than the(1.96±0.21)μmmol/L in the control group(P<0.05);the levels ofβ2-MG,Cys C and iPTH in the study group were(9.24±0.81)mg/L,(3.86±0.34)mg/L and(461.75±38.95)pg/ml,respectively,which were lower than the(9.88±0.95)mg/L,(5.23±0.49)mg/L and(526.39±49.71)pg/ml in the control group(P<0.05);the level of PL in the study group was(302.16±26.74)ms,which was lower than the(325.81±31.25)ms in the control group,moreover,the level of Amp in the study group was(9.38±0.92)μV,which was higher than the(8.19±0.81)μV in the control group(P<0.05).There were no significant differences in the levels of nPCR,TACruea and Kt/A between the study group and the control group(P>0.05).Conclusions Both HDF and HFHD can clear toxins in uremia patients with CRF to

关 键 词：慢性肾衰竭 尿毒症 高通量血液透析 血液透析滤过 

分 类 号：R692.5[医药卫生—泌尿科学]