连续性血液净化和间歇性血液透析对老年急性肾功能衰竭患者血清RBP4 Tfβ_(2)-MG水平的影响  

Effects of Continuous Blood Purification and Intermittent Hemodialysis on Serum RBP4 Tf andβ_(2)-MG Levels in Elderly Patients with Acute Renal Failure

作　　者：何丽 张凡 程彩娟 曹路路 唐琪 李奕 HE Li;ZHANG Fan;CHENG Caijuan(Western Theater General Hospital,Sichuan Chengdu 610000,China)

机构地区：[1]西部战区总医院肾脏病科血液净化中心,四川成都610000

出　　处：《河北医学》2024年第1期71-75,共5页Hebei Medicine

基　　金：四川省干部保健科研课题,(编号:川干研2021-1301)。

摘　　要：目的:探讨连续性血液净化(CBP)和间歇性血液透析(IHD)对老年急性肾功能衰竭(ARF)患者血清视黄醇结合蛋白4(RBP4)、转铁蛋白(Tf)、β_(2)微球蛋白(β_(2)-MG)水平的影响。方法:纳入2021年1月至2023年1月在我院收治的114例ARF患者为本次研究的研究对象,采取随机数字表对入组ARF患者进行简单随机分组,各57例(观察组、对照组)。对照组予以IHD,观察组予以CBP,两组患者透析周期均为2周。比较两组患者临床疗效,透析前、透析2周后血清检测水平[RBP4、Tf、β_(2)-MG、Scr和BUN]与电解质指标(K^(+)、Cl^(-)、Na^(+)),记录两组患者并发症发生情况。结果:透析结束后,观察组与对照组ARF患者总有效率分别为94.74%(54/57)、78.95%(45/57),差异有统计学意义(P<0.05)。透析2周后两组患者血清RBP4、Tf、β_(2)-MG、Scr、BUN水平较之透析前明显降低,且观察组血清RBP4、Tf、β_(2)-MG、Scr、BUN水平下降幅度均大于对照组(P<0.05)。透析2周后两组患者血清K^(+)、Cl^(-)和Na^(+)水平较之透析前明显升高,且观察组K^(+)、Cl^(-)和Na^(+)水平升高幅度均大于对照组(P<0.05)。两组ARF患者透析期间并发症发生率(5.26%、7.02%)比较差异不显著(P>0.05)。结论:老年ARF患者应用CBP透析效果较好,可以较大程度清除血液中的大小分子毒素,并维持电解质的稳定。Objective:To explore the effects of continuous blood purification(CBP)and intermittent hemodialysis(IHD)on levels of serum retinol-binding protein 4(RBP4),transferrin(Tf)andβ_(2)-microglobulin(β_(2)-MG)in elderly patients with acute renal failure(ARF).Methods:A total of 114 ARF patients admitted to our hospital from January 2021 to January 2023 were included in this study.The patients were randomly divided into two groups using a random number table,with 57 cases in each group(observation group and control group).The control group received IHD,and the observation group received CBP,with a dialysis period of 2 weeks for both groups.Clinical efficacy,serum levels[RBP4,Tf,β_(2)-MG,Serum Creatinine(Scr),and Blood Urea Nitrogen(BUN)]before and 2 weeks after dialysis,as well as electrolyte indicators(K^(+),Cl^(-),Na^(+)),were compared between the two groups.Complications during the treatment were recorded.Results:After dialysis,the total effective rates in the observation group and control group were 94.74%(54/57)and 78.95%(45/57),respectively,with a statistically significant difference(P<0.05).After 2 weeks of dialysis,the serum levels of RBP4,Tf,β_(2)-MG,Scr,and BUN in both groups decreased significantly com-pared to before dialysis,and the reduction in the observation group was greater than that in the control group(P<0.05).After 2 weeks of dialysis,the serum levels of K^(+),Cl^(-),and Na^(+)in both groups increased signifi-cantly compared to before dialysis,and the increase in the observation group was greater than that in the con-trol group(P<0.05).The incidence of complications during dialysis in both groups(5.26%,7.02%)showed no significant difference(P>0.05).Conclusion:CBP is more effective in elderly ARF patients,ef-fectively removing small and large molecular toxins from the blood and maintaining electrolyte stability.

关 键 词：急性肾功能衰竭 连续性血液净化 间歇性血液透析 视黄醇结合蛋白4 转铁蛋白 β_(2)微球蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]