关于在线血液透析滤过治疗时置换液不同补充模式对溶质清除效率的影响  

Effect of Different Replenishment Modes of Replacement Fluid on Solute Clearance Efficiency during Online Hemodiafiltration Therapy

作　　者：谭亚贵[1] 简建业 凌宇凤 TAN Yagui;JIAN Jianye;LING Yufeng(Department of Nephrology,Wuchuan People's Hospital,Wuchuan,Guangdong Province,524500 China)

机构地区：[1]吴川市人民医院肾内科,广东吴川524500

出　　处：《系统医学》2024年第10期5-8,共4页Systems Medicine

基　　金：湛江市科技计划项目(2022B01106)。

摘　　要：目的探讨在线血液透析滤过治疗患者在进行血液透析时置换液不同补充模式对溶质清除率及生活质量的影响。方法选取2022年8月—2023年11月吴川市人民医院收治的90例行维持性血液净化治疗的尿毒症患者为研究对象,依据不同补液方式分为A组(单纯前稀释血液透析滤过,置换液补充在滤器前)、B组(单纯后稀释血液透析滤过,置换液补充在滤器后)、C组(3∶2前后混合稀释血液透析滤过),各30例。比较3组滤过情况和心血管指标。结果3组治疗后血磷、β2-微球蛋白、尿素氮下降率、血肌酐下降率对比,差异有统计学意义(P均<0.05)。A组对比B组和C组的血磷、β2-微球蛋白、尿素氮下降率和血肌酐下降率水平,差异有统计学意义(P均<0.05)。治疗后3组左心室射血分数(Left Ventricular Ejection Fraction,LVEF)较治疗前升高,颈动脉中膜厚度(Carotid Intima-media Thickness,CIMT)较治疗前降低,B组和C组治疗后左室重量指数(Left Ventricular Mass Index,LVMI)较治疗前降低,差异有统计学意义(P均<0.05)。3组患者LVMI[(145.52±10.08)g/m^(2) vs(130.04±9.85)g/m^(2)vs(136.25±10.28)g/m^(2)]、LVEF[(62.24±6.61)%vs(69.85±5.74)%vs(65.04±6.52)%]和CIMT[(1.26±0.12)mm vs(1.10±0.10)mm vs(1.18±0.10)mm]比较,差异有统计学意义(F=17.951、11.191、16.740,P均<0.05)。结论后稀释模式溶质清除率优于前稀释和混合稀释模式,并改善患者心血管指标。Objective To investigate the effect of different replenishment modes of replacement fluid on solute clear⁃ance and quality of life in patients undergoing online hemodiafiltration therapy.Methods A total of 90 patients with uremia who received maintenance blood purification treatment in Wuchuan People's Hospital from August 2022 to No⁃vember 2023 were selected as the study subjects.They were divided into group A(pure pre-diluted hemodiafiltration,replacement fluid in front of the filter),group B(hemodiafiltration after pure dilution,and the replacement solution was added after the filter),and group C(3:2 before and after mixed dilution hemodiafiltration)based on different fluid replacement methods,with 30 cases in each group.The filtration status and cardiovascular indicators among three groups were compared.Results After treatment,the blood phosphorus,β2-microglobulin,decrease rates of urea nitro⁃gen and creatinine in three groups were compared,and the differences were statistically significant(all P<0.05).The blood phosphorus,β2-microglobulin,decrease rates of urea nitrogen and serum creatinine in group A were compared with those in group B and group C,and the differences were statistically significant(all P<0.05).After treatment,the left ventricular ejection fraction(LVEF)in the three groups was increased compared with that before treatment,and the carotid intima-media thickness (CIMT) was reduced compared with that before treatment, the left ventricular mass index (LVMI) in group B and group C after treatment was lower than that before treatment, and the differences were statistically significant (all P<0.05). LVMI [(145.52±10.08) g/m^(2) vs (130.04±9.85) g/m^(2) vs (136.25±10.28) g/m^(2)] and LVEF [(62.24±6.61) % vs (69.85±5.74) % vs (65.04±6.52) %] and CIMT [(1.26±0.12) mm vs (1.10±0.10) mm vs (1.18±0.10) mm] of 3 groups were compared, and the differences were statistically significant (F=17.951, 11.191, 16.740, all P<0.05). Conclusion The solute clearance rate in post-dilution mode was bett

关 键 词：血液透析滤过 前后混合稀释 心血管指标 Β2微球蛋白 

分 类 号：R692.5[医药卫生—泌尿科学]