不同血液净化方式治疗终末期糖尿病肾病的临床对比  

Clinical Comparison of Different Blood Purification Methods in the Treatment of End-stage Diabetic Nephropathy

作　　者：李婉莎 蔡华裕 王声望 LI Wansha;CAI Huayu;WANG Shengwang(Department of Nephrology,Quanzhou First Hospital,Quanzhou 362000,Fujian,China;Department of Urology,Jinjiang Hospital,Jinjiang 362200,Fujian,China)

机构地区：[1]泉州市第一医院肾内科,福建泉州362000 [2]晋江市医院泌尿外科,福建晋江362200

出　　处：《糖尿病新世界》2024年第18期167-170,共4页Diabetes New World

摘　　要：目的探究不同血液净化方式治疗终末期糖尿病肾病的临床效果。方法回顾性选取2022年6月—2023年12月泉州市第一医院收治的96例终末期糖尿病肾病患者的临床资料,按照治疗方式的不同分为对照1组、对照2组和观察组,各32例。对照1组患者接受低通量血液透析(hemodialysis,HD)治疗,对照2组患者接受血液透析滤过治疗,观察组患者接受HD+血液灌流治疗。对比3组血清甲状旁腺激素(parathyroid hormone,PTH)清除率、胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR)及微炎症状态指标、不良反应发生率。结果观察组血清PTH清除率高于对照1组、对照2组,HOMA-IR低于对照1组、对照2组,差异有统计学意义(P均<0.05)。观察组超敏C反应蛋白、白细胞介素-6、肿瘤坏死因子-α水平低于对照1组、对照2组,差异有统计学意义(P均<0.05)。观察组不良反应发生率低于对照1组、对照2组,差异有统计学意义(P<0.05)。结论终末期糖尿病肾病患者采取血液透析+血液灌流治疗效果较理想,可有效改善患者胰岛素抵抗指数、微炎症状态,且不良反应发生率较低。Objective To explore the clinical effect of different blood purification methods in treating end-stage diabetic nephropathy.Methods Clinical data of 96 patients with end-stage diabetic nephropathy treated in Quanzhou First Hospital from June 2022 to December 2023 were retrospectively selected,and were divided into control group 1,control group 2 and observation group according to different treatment methods,with 32 cases each.Control group 1 patients had hemodialysis(HD),control group 2 patients had hemodiafiltration,and observation group patients had HD+hemoperfusion.The serum parathyroid hormone(PTH)clearance rate,homeostasis model assessment-insulin resistance(HOMA-IR),micro-inflammatory state index and incidence of adverse reactions were compared among the three groups.Results The serum PTH clearance rate in the observation group was higher than that in control group 1 and control group 2,and HOMA-IR was lower than that in control group 1 and control group 2,and the differences were statistically significant(both P<0.05).The levels of hypersensitive C-reactive protein,interleukin-6 and tumor necrosis factor-αin observation group were lower than those in control group 1 and control group 2,and the differences were statistically significant(all P<0.05).The incidence of adverse reactions in observation group was lower than that in control group 1 and control group 2,and the difference was statistically significant(P<0.05).Conclusion Hemodialysis+hemoperfusion for patients with end-stage diabetic nephropathy has an ideal effect,which can effectively improve the insulin resistance index and micro-inflammatory state of patients,and the incidence of adverse reactions is low.

关 键 词：血液净化 终末期糖尿病肾病 血清甲状旁腺激素清除率 胰岛素抵抗指数 

分 类 号：R587.1[医药卫生—内分泌]