高通量低钙血液透析对老年尿毒症患者血清MCP-1、β_(2)-MG水平及尿素清除指数的影响  

Effects of High-flux Low-calcium Hemodialysis on Serum MCP-1,β_(2)-MG and Urea Clearance Index in Elderly Patients with Uremia

作　　者：孔子昂 葛郡 袁娟 KONG Ziang;GE Jun;YUAN Juan(Department of Nephrology,East Campus of Jiamusi Central Hospital,Jiamusi,Heilongjiang 154002,China)

机构地区：[1]佳木斯市中心医院东院区肾内科,黑龙江佳木斯154002

出　　处：《临床误诊误治》2024年第13期62-65,70,共5页Clinical Misdiagnosis & Mistherapy

基　　金：黑龙江省卫生健康委科研课题(20230303050501)。

摘　　要：目的分析高通量低钙血液透析用于老年尿毒症的效果。方法选取2017年12月至2022年6月收治的老年尿毒症380例,随机数字表法分为对照组、观察组,每组190例。对照组行低通量血液透析,观察组行高通量低钙血液透析。比较2组肾功能[血肌酐(Scr)、血尿素(BUN)、β_(2)-微球蛋白(β_(2)-MG)]、单核细胞趋化蛋白-1(MCP-1)、血清钙磷代谢指标及尿素清除指数(Kt/V)情况。结果观察组总有效率92.63%高于对照组73.68%(P<0.05)。治疗后,观察组Scr、BUN、β_(2)-MG、MCP-1、血清钙、血清磷水平较对照组下降(P<0.05);观察组Kt/V较对照组升高(P<0.05)。2组不良反应发生率比较无统计学差异(P>0.05)。结论老年尿毒症患者采用高通量低钙血液透析,效果较为理想,可显著降低血清MCP-1水平,提高Kt/V,临床应用价值较高。Objective To analyze the efficacy of high-flux low-calcium hemodialysis in the treatment of elderly patients with uremia.Methods In total,380 elderly patients with uremia treated from December 2017 to June 2022 were selected and divided into control group and observation group by random number table method,with 190 patients in each group.The control group received low-flux hemodialysis,and the observation group received high-flux low-calcium hemodialysis.The renal function[serum creatinine(Scr),blood urea nitrogen(BUN),β_(2)-microglobulin(β_(2)-MG)],monocyte chemoattractant protein-1(MCP-1),serum calcium and phosphorus metabolism indexes and urea clearance index(Kt/V)of the two groups were compared.Results The total effective rate of observation group was 92.63%,which was higher than that of control group(73.68%)(P<0.05).After treatment,the levels of Scr,BUN,β_(2)-MG,MCP-1,serum calcium and serum phosphorus in observation group were decreased compared with those in control group(P<0.05).Kt/V in the observation group was increased as compared with that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion High-flux low-calcium hemodialysis is an ideal treatment option for elderly patients with uremia,which can obviously reduce serum MCP-1 level and increase Kt/V,and has high clinical application value.

关 键 词：尿毒症 高通量血液透析 低钙透析液 低通量血液透析 老年 单核细胞趋化蛋白-1 β_(2)-微球蛋白 尿素 

分 类 号：R692.5[医药卫生—泌尿科学]