腹膜透析对慢性肾衰竭患者氧化应激及钙磷代谢的影响  

Effects of Peritoneal Dialysis on Oxidative Stress and Calcium and Phosphorus Metabolism in Patients with Chronic Renal Failure

作　　者：何国斌[1] 郭利芹 王焕[1] HE Guo-bin;GUO Li-qin;WANG Huan(Department of Nephrology,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China)

机构地区：[1]新乡市中心医院肾内科,河南新乡453000

出　　处：《罕少疾病杂志》2024年第8期80-82,共3页Journal of Rare and Uncommon Diseases

基　　金：河南省医学科技攻关计划项目(LHGJ20220988)。

摘　　要：目的探讨腹膜透析在慢性肾衰竭(CRF)患者中的应用价值。方法回顾性分析2020年7月至2022年7月我院收治的CRF患者94例的临床资料。按照透析方式的不同进行分组,行血液透析的47例CRF患者为对照组,行腹膜透析的47例CRF患者为观察组,两组均治疗6个月。对比分析两组氧化应激、钙磷代谢、炎症因子水平、肾功能、营养状态及并发症。结果治疗后,观察组丙二醛(MDA)(9.04±1.18)nmol/mL、髓过氧化物酶(MPO)(6.32±1.05)U/L、磷离子(1.38±0.26)mmol/L、超敏C反应蛋白(hs-CRP)(7.31±1.09)mg/L、肿瘤坏死因子-α(TNF-α)(35.31±3.54)ng/L、白介素(IL)-6(32.50±3.28)pg/L、IL-8(47.31±5.48)pg/L、尿素氮(BUN)(19.27±2.54)mmol/L、血肌酐(Scr)(461.47±21.46)μmol/L、白蛋白(ALB)(30.94±2.88)g/L,低于对照组的(11.26±1.53)nmol/mL、(8.06±1.42)U/L、(1.65±0.38)mmol/L、(9.26±1.57)mg/L、(42.58±4.39)ng/L、(38.21±4.31)pg/L、(60.48±7.31)pg/L、(22.49±3.08)mmol/L、(497.69±23.86)μmol/L、(33.89±2.17)g/L,超氧化物歧化酶(SOD)(159.58±7.82)U/mL、总抗氧化能力(T-AOC)(7.48±1.22)U/L、血红蛋白(Hb)(117.95±12.75)g/L,高于对照组的(137.77±7.26)U/mL、(5.19±0.96)U/L、(106.79±11.84)g/L,差异有统计学意义(P<0.05);治疗后,两组钙离子相近,且两组并发症总发生率相近,差异无统计学意义(P>0.05)。结论腹膜透析能够更好的减轻CRF患者机体氧化应激损伤,调节钙磷代谢,抑制炎症反应,改善肾功能,提高Hb水平,但治疗中可能造成ALB下降,引发低蛋白血症,故临床需及时补充ALB,提高治疗安全性。Objective To explore the application value of peritoneal dialysis in patients with chronic renal failure(CRF).Methods The clinical data of 94 patients with CRF admitted to our hospital from July 2020 to July 2022 were analyzed retrospectively.According to different dialysis methods,47 CRF patients undergoing hemodialysis were divided into control group and 47 CRF patients undergoing peritoneal dialysis were divided into observation group.Both groups were treated for 6 months.The oxidative stress,calcium and phosphorus metabolism,inflammatory factor level,renal function,nutritional status and complications of the two groups were compared and analyzed.Results After treatment,in the observation group,malondialdehyde(MDA)(9.04±1.18)nmol/mL,myeloperoxidase(MPO)(6.32±1.05)U/L,phosphorus ion(1.38±0.26)mmol/L,hypersensitive C-reactive protein(hs-CRP)(7.31±1.09)mg/L,tumor necrosis factor(TNF)-α(TNF-α)(35.31±3.54)ng/L,interleukin(IL)-6(32.50±3.28)pg/L,IL-8(47.31±5.48)pg/L,urea nitrogen(BUN)(19.27±2.54)mmol/L,serum creatinine(Scr)(461.47±21.46)μMol/L,albumin(ALB)(30.94±2.88)g/L,lower than that of the control group(11.26±1.53)nmol/L,(8.06±1.42)U/L,(1.65±0.38)mmol/L,(9.26±1.57)mg/L,(42.58±4.39)ng/L,(38.21±4.31)pg/L,(60.48±7.31)pg/L,(22.49±3.08)mmol/L,(497.69±23.86)μMol/L,(33.89±2.17)g/L,superoxide dismutase(SOD)(159.58±7.82)U/L,total antioxidant capacity(T-AOC)(7.48±1.22)U/L,hemoglobin(Hb)(117.95±12.75)g/L,which were significantly higher than those of the control group(137.77±7.26)U/L,(5.19±0.96)U/L,(106.79±11.84)g/L(P<0.05);after treatment,the calcium ions in the two groups were similar,and the total incidence of complications in the two groups was similar,the difference was not statistically significant(P>0.05).Conclusion Peritoneal dialysis can better alleviate the oxidative stress injury of CRF patients,regulate calcium and phosphorus metabolism,inhibit inflammatory reaction,improve renal function,and increase the level of Hb.However,the treatment may cause the decline of ALB and lead to hypo

关 键 词：慢性肾衰竭 腹膜透析 氧化应激 钙磷代谢 炎症因子 肾功能 营养状态 

分 类 号：R473.5[医药卫生—护理学]